The value of ultrasonography as a screening procedure in a first-documented urinary tract infection in children.

To evaluate the role of ultrasonography in the investigation of childhood urinary tract infections (UTI), 240 patients aged 2 days to 15 years with a first-documented UTI were examined first by sonography, then by intravenous urography (IVU), and when indicated by voiding cysto-urethrogram (VCU). According to the results of these examinations, the patients were divided into three groups. In Group 1 (71 patients), abnormal sonographic findings were confirmed by the radiographic studies. Patients in Group 2 (51 patients) had discrepancies between sonographic and radiographic findings, the most important of which concerned the assessment of vesico-ureteric reflux (VUR). In Group 3 (118 patients), sonographic and subsequent radiographic investigations were normal. Although ultrasonography can sometimes detect VUR, major reflux can be missed by sonography alone. In young children at risk for reflux nephropathy, ultrasound examination of the urinary tract must be accompanied by a VCU or isotope cysto-urethrogram.