Ultrasonography as a screening procedure in children with urinary tract infection.

Renal ultrasonography, excretory urography and radionuclide-voiding cystography or conventional voiding cystourethrography were performed in 76 children with urinary tract infection. Forty children had functional or anatomical abnormalities. Twenty-eight children had vesicoureteral reflux and 12 children had an obstructive lesion. All 12 children with obstructive lesions as well as 4 children with reflux and hydronephrosis required corrective surgery. Ultrasonography as the initial procedure detected 14 of these cases and the other 2 were discovered in voiding cystourethrography. Our data and those in the literature suggest that renal ultrasonography may be the method of choice in children with urinary tract infection. This is followed by voiding cystourethrography or radionuclide-voiding cystography. Excretory urography is not necessary in the initial evaluation of these patients, but it should be utilized when the other imaging methods show an abnormality and more detailed anatomical visualization of the upper urinary tract is required. Using this protocol in children with urinary tract infection, unnecessary radiation, discomfort and expense will be avoided.