When are imaging studies indicated in the workup of pediatric urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Imaging studies are not indicated for infants and children with a first episode of cystitis or for those with a first febrile UTI who meet the following criteria:

  • Assured follow-up

  • Prompt response to treatment (afebrile within 72 h)

  • A normal voiding pattern (no dribbling)

  • No abdominal mass

If imaging studies of the urinary tract are warranted, they should not be obtained until the diagnosis of UTI is confirmed. Febrile infants aged 2-24 months with UTIs should undergo renal and bladder ultrasonography. [3] Other indications for ultrasonography of the urinary tract after a febrile UTI in pediatric patients are as follows:

  • Delayed or unsatisfactory response to treatment of a first febrile UTI

  • An abdominal mass or abnormal voiding (dribbling of urine)

  • Recurrence of febrile UTI after a satisfactory response to treatment

Finally, renal ultrasonography should be considered for any child with a first febrile UTI in whom good follow-up cannot be ensured.


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