Imaging after UTI: decision aid
Explains indications for ultrasound, VCUG and DMSA after febrile UTI according to EAU 2026.
Result
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Formula and thresholds
EAU 2026: ultrasound within 24 hours in infants with febrile UTI and acutely ill children; VCUG (or contrast voiding urosonography) not in the acute phase, selectively: after a first febrile UTI under 12 months (regardless of ultrasound), recurrent febrile UTI, abnormal ultrasound or DMSA, atypical UTI at any age. DMSA: shows pyelonephritis in the acute phase; for scarring, at least 6 months after infection.
Clinical note
This aid shows the logic of the recommendations; the treating doctor makes the decision. With a typical infection and a normal ultrasound, deferring VCUG until a second febrile episode is an acceptable option, especially over 12 months of age. In the top-down approach, DMSA is done first and VCUG is planned only if DMSA is abnormal. In a toilet-trained child, bladder and bowel dysfunction must be looked for and treated; it is one of the main causes of recurrent UTI.
This calculator is for medical professionals and does not replace clinical judgement. Do not enter the patient’s name: data is not sent anywhere and is processed only in your browser.
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