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Vesicoureteric Reflux — RACP Paediatrics MCQ

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ModerateNephrologyVesicoureteric RefluxRACP Paediatrics

An 8-year-old girl with a first febrile UTI has a renal ultrasound showing bilateral hydronephrosis and scarring of the right kidney. DMSA scan confirms a scarred right kidney with differential function of 35% on the right. What additional investigation is indicated?

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Correct answer: D — Micturating cystourethrogram (MCUG)

An MCUG is indicated when renal ultrasound shows abnormalities such as hydronephrosis, scarring, or other structural anomalies, as vesicoureteric reflux (VUR) needs to be assessed. The degree of reflux guides management decisions including antibiotic prophylaxis or surgical intervention. DMSA confirms renal scarring but MCUG is needed to evaluate the underlying cause.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Urinary Tract Infection