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Volume 348:1812-1814 May 1, 2003 Number 18
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Imaging Studies after a First Febrile Urinary Tract Infection in Young Children

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by Hoberman, A.
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To the Editor: Hoberman et al. (Jan. 16 issue)1 attribute the small effect of renal ultrasonography in the clinical management of febrile urinary tract infections to the widespread use of prenatal ultrasonography. However, reports and images from intrauterine ultrasonography are often unavailable, and the risk of missing a clinically significant obstructive lesion, given a history of normal prenatal ultrasonographic findings, has not been determined.2

For example, obstruction of the ureteropelvic junction is commonly diagnosed prenatally. However, in the era before ultrasonography, 27 percent of patients with such obstructions presented with a urinary tract infection,3 and the disorder might be missed . . . [Full Text of this Article]



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