Indications for imaging studies:
(1) severe infection with urosepsis
(2) male, except sexually active young man
(3) complicated UTI
(4) young woman with atypical cases of pyelonephritis (persistent hematuria, colicky pain)
(5) young woman with slow (> 72 hours) or no resolution of symptoms despite appropriate antibiotic therapy
(6) recurrent pyelonephritis
(7) relapse, with recurrence of UTI within 2 weeks after completion of therapy with the same organism
Imaging studies:
(1) Ultrasonography (US) and computed tomography (CT) are the primary modalities for imaging the urinary tract in cases of urinary tract infection.
(2) Ultrasound can identify many obstructive lesions, abscesses, gas collection and renal features.
(3) CT scans can give more precise images but is more expensive.
(4) Intravenous pyelography (IVP) has largely been supplanted by these techniques.
(5) Voiding cystourethrography may be used in patients being evaluated for vesicoureteral reflux.