© 2004 BMJ Publishing Group & Royal College of Paediatrics and Child Health
COMMENTARY
Imaging
Imaging guidelines for urinary tract infection in childhood; time for change?
Correspondence to:
Correspondence to:
Dr T J Beattie
Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, UK; Jim.Beattie{at}yorkhill.scot.nhs.uk
Commentary on the paper by Zamir et al
Keywords: ultrasound; urinary tract infection; vesicoureteral reflux; voiding cystourethrogram
| The first 150 words of the full text of this article appear below. |
Despite the frequency of urinary tract infection (UTI) in childhood,1 and the numerous contributions on the subject in the literature, there is surprisingly little consensus on urinary tract imaging requirements, perhaps reflecting the paucity of high quality intervention studies and data on long term outcome.
Diagnostic imaging following UTI in childhood has been accepted practice for nearly 40 years since the original studies2 showed a high prevalence of abnormalities, and specifically a link between renal scarring and vesicoureteric reflux (VUR). Inherent in this strategy was the assumption that identification of these abnormalities would influence outcome. In the intervening decades, much has been learned about additional risk factors for post-infection renal scarring, such as obstructive uropathy, recurrent febrile UTI, particularly in the infant and young child, diagnostic delay, inadequate treatment, dysfunctional voiding, the host inflammatory reaction, as well as factors specific to the infecting bacterium.3
In addition, clear gender specific
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