Left kidney showing a duplicated collecting system Figure 5: Sagittal gray scale image of the left kidney showing a duplicated collecting system. An 18-month-old girl returns for a follow-up appointment with her urologist. She has a history of grade 3 vesicoureteral reflux (VUR) into the lower pole of a duplex left kidney identified at 4 months of age following febrile urinary tract infections (UTI). (See Figure 5.) She is healthy, takes prophylactic antibiotics, and has not experienced additional UTIs. Her growth and development are normal.

What imaging study will help guide her further care?

What is your advice for this family?

Please submit your advice below. A collection of answers will be included in the next issue of Children's Doctor.

Diana Montoya-Williams, MD, a CHOP neonatologist, submitted the first correct answer to last issue’s quiz, acute flaccid myelitis, which is the subject of this issue’s cover story.

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