TY - JOUR T1 - Atoms JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 87 LP - 87 DO - 10.1136/adc.87.2.87-a VL - 87 IS - 2 AU - Harvey Marcovitch Y1 - 2002/08/01 UR - http://adc.bmj.com/content/87/2/87.2.abstract N2 - Daytime wetting is a common reason for referral to general and community paediatric clinics. Investigations are rarely necessary, beyond excluding urinary tract infection, polyuria, psychological distress and—perhaps—constipation. Such a course of action will miss the few children who have neuropathic vesicourethral dysfunction in association with a spinal cord anomaly. Diagnosis is by MRI of the spine but the indications are not clear. This month we publish a retrospective study of children referred from a tertiary neuro-urology clinic for exclusion of such an anomaly. Forty-eight children were studied, 5 proving positive. Wraige and Borzyskowski from Guy's Hospital, London have used their findings to offer guidance on which children merit imaging, including in their paper a suggested investigative protocol You should think MRI if daytime wetting is associated with abnormal neurological signs in the lower limbs, an abnormal lumbar spine x ray, lumbosacral birthmarks, or anorectal anomalies. Think twice, but do videourodynamic studies first, in … ER -