Ultrasound kidneys is recommended in all cases with UTI irrespective of age.
Dimercaptosuccinic acid scan (DMSA) should only be done after 3 to 4 months of treatment to detect renal scarring in children between 1-5 year of age with first UTI. In children older than 5 years it is recommended only if ultrasound kidneys is abnormal. It is not recommended for diagnosing acute pyelonephritis to avoid unnecessary radiation exposure.
Micturition cystourethrography (MCU) /Voiding cystourethrography (VCUG) can be done any time during or after treatment, under antibiotic coverage. It is indicated in children more than one year of age with abnormal ultrasound and/or DMSA scan.
Any child with recurrent UTI or age less than 1 year with first episode of UTI need all the three imaging studies, ultrasound kidneys, DMSA scan and MCU/VCUG.
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