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US demonstration of pyelitis and ureteritis in children
E F Avni1, D Van Gansbeke, Y Thoua
1Department of Radiology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Belgium.
Insights
A new ultrasonic sign, renal pelvis and ureteral wall thickening, indicates urinary tract infections in children. This finding aids in diagnosing pyelitis and ureteritis, prompting further investigation and treatment.
Area of Science:
- Pediatric Nephrology
- Diagnostic Ultrasound
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common in children.
- Early diagnosis is crucial to prevent renal damage.
- Current diagnostic methods may have limitations in identifying all cases.
Purpose of the Study:
- To identify a novel sonographic sign for detecting UTIs in pediatric patients.
- To correlate ultrasonic findings with clinical and radiological data in children with UTIs.
Main Methods:
- Retrospective analysis of ultrasound findings in 10 children diagnosed with UTIs.
- Evaluation of renal pelvis and ureteral wall thickness on ultrasound.
- Comparison with intravenous pyelogram findings and presence of vesicoureteral reflux.
Main Results:
- A distinct thickening of the renal pelvis and/or ureteral wall was observed in all 10 children with UTIs.
- This thickening is attributed to inflammatory changes, indicative of pyelitis and ureteritis.
- In two cases, wall thickening was the sole ultrasonic abnormality; in four, it occurred without reflux.
Conclusions:
- Renal and ureteral wall thickening on ultrasound is a significant indicator of UTIs in children.
- This sonographic sign can aid in the diagnosis of pyelitis and ureteritis, even in the absence of reflux.
- The identification of this pattern warrants further uroradiological investigation and timely management.
Abstract:
The authors report a new ultrasonic sign of urinary tract infection in children: thickening of the renal pelvis and/or ureteral wall. This thickening as encountered in 10 children, (10 months to 12 years) all with urinary tract infection, appears to result from inflammatory changes and to correspond to a sonographic sign of pyelitis and ureteritis. These alterations of the walls are similar to striations and folds described in this pathology on intravenous pyelograms. The thickening was the only sign of abnormality of the urinary tract in two cases; it was observed without reflux in four cases. The demonstration of this pattern should lead to further uroradiological investigations and to appropriate treatment.