In children diagnosed with a urinary tract infection between 2 months and 2 years, which diagnostic test is appropriate?

In children diagnosed with a urinary tract infection (UTI) between the ages of 2 months and 2 years, a voiding cystourethrogram (VCUG) or a radionuclide cystogram is appropriate to assess for possible underlying anatomical abnormalities, including vesicoureteral reflux (VUR). This age group is at higher risk for VUR, which is a condition where urine flows backward from the bladder into the kidneys, potentially leading to recurrent infections and renal scarring.

In most cases, after an initial UTI diagnosis, a VCUG is performed to evaluate the bladder and urethra as the child voids, allowing for the visualization of the urinary tract during urination. If VUR is detected, appropriate management can be initiated to prevent complications.

Urinalysis, while crucial for diagnosing the initial infection, does not provide information about the anatomy of the urinary tract. An ultrasound, although helpful in assessing the kidneys and bladder for gross abnormalities or hydronephrosis, is not specific for detecting VUR and does not replace the need for a VCUG. A CT scan is generally not warranted in this situation, especially considering the exposure to radiation and the availability of more effective and safer diagnostic methods like VCUG or