Imaging study VCUG not necessary in first Urinary Tract Infection in young Children
If your child has a documented urinary tract infection and your primary care physician recommends an imaging study called VCUG, please ask him or her Evidence Based Medicine study supporting their recommendation.
There no evidence to support clinical effectiveness of routine investigation of children younger than 5 years old with proven urinary tract infection. Randomized trial found no benefit for routine imaging in children aged 2-10 years with first uncomplicated UTI, described in detail under Imaging studies below; diagnostic accuracy studies suggest contrast-enhanced ultrasound as an alternative to voiding cystourethrogram (VCUG) for detecting vesico-ureteric reflux (VUR), but benefit of VUR detection not demonstrated (BMC Pediatrics 2005 Mar 15;5:2)
The policy of the American Academy of Pediatrics regarding urinary tract infection and doing VCUG for first UTI with fever needs to be change to reflect the latest randomized trials.
Leo Leonidas, MD, FAAP