Urinary tract infections: Role of imaging in the management

Performing the appropriate diagnostic evaluation of urinary tract infections is an important part of women's health care. With one in three women requiring treatment for a UTI by age 24, this is a common diagnosis in which the use of an appropriate imaging modalities can aid with both diagnosis and treatment planning. The use of imaging varies based on various patient factors, including the temporality and location (i.e., upper versus lower tract). Computer tomography (CT) with contrast remains the gold standard diagnostic tool for pyelonephritis. Ultrasound and MRI serve as alternatives to CT when hoping to avoid radiation or iodinated contrast. In patients experiencing recurrent infections, cystoscopy evaluation of the bladder may be warranted to evaluate the bladder and urethra. Other upper tract imaging studies, such as CT without contrast, provide better evaluation of the presence of a stone that may be causing chronic or recurrent infections. Less common imaging studies such as Tc-99m DMSA scan are used in pediatrics to provide evaluation for congenital abnormalities and renal scarring. Familiarity with the imaging options for urinary tract infection evaluation is important for providing the patient with an accurate diagnosis and with guiding clinicians with treatment.