Ultrasound Screenings After UTI in Children May Miss Abnormalities if Limited to Under-2: Study Suggests

Current clinical guidelines in many countries recommend conducting a urinary tract ultrasound only in children under the age of two following a UTI. However, the study highlights that this approach could result in missing nearly one-third of children with abnormalities, as 30% of the abnormal findings in pyelonephritis cases occurred in children older than two.

“Our findings suggest that the existing age cut-off in guidelines may not be sufficient to detect all cases of urinary tract abnormalities after UTI,” the researchers noted. They advocate for expanding ultrasound screening to include all children after their first episode of pyelonephritis, irrespective of age.

The authors call for a reassessment of current diagnostic protocols and recommend that future research adopt a prospective, longitudinal approach encompassing children of all ages diagnosed with UTI. This would offer a clearer understanding of the risk distribution and help optimize screening strategies to improve early detection of potential complications.

The authors concluded, "The study urges pediatricians and healthcare policymakers to reconsider current practices surrounding post-UTI imaging. Broadening the screening criteria could play a key role in early identification and management of urinary tract abnormalities, thereby improving outcomes for affected children."

Reference:

Hakkola, M., Tervo, I., Pieviläinen, O., Heiskanen, J., Honkila, M., Pokka, T., Paalanne, N., Venhola, M., Perhomaa, M., & Ruuska-Loewald, T. Abnormal Ultrasound Findings After a Urinary Tract Infection in Children. Acta Paediatrica. https://doi.org/10.1111/apa.70152