Case 306

Medical history

Infant at 3 months, female, on right hydronephrosis investigation. Diagnosed in the prenatal ultrasonography performed at the 37th week of gestation (diameter of the renal pelvis: right 21.6 mm, left: 5.2 mm, normal volume of amniotic fluid). With 15 days of life, has been performed a ultrasonography of the kidneys and urinary tract which revealed right renal pelvis diameter of 19.6 mm. At 2 months and 20 days of life, a new ultrasound detected an increase in the diameter of the right renal pelvis to 22.9 mm and voiding uretrocistography (without changes) and renal scintigraphy (static and dynamic, attached) were performed. Normal physical exam and laboratory data. In regular prophylactic use of cephalexin 12.5 mg / kg / day, without episodes of urinary tract infection.

Considering the clinical picture and scintigraphy presented, what diagnosis is most likely?

Test Question

Medical Residence of Hospital Universitário Antônio Pedro – RJ (2014) A 4-year-old female, has a recurrent urinary tract infection and vesicoureteral reflux.
The most effective test to demonstrate the presence of possible renal scarring is:

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