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Pediatric urolithiasis: what can pediatricians expect from radiologists? | LitMetric

Pediatric urolithiasis: what can pediatricians expect from radiologists?

Pediatr Radiol

Service d'imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.

Published: April 2023

AI Article Synopsis

  • * Unlike adults, where environmental factors are major contributors, children more frequently experience secondary causes of urolithiasis, particularly in recurrent cases with family history.
  • * Ultrasound is the primary imaging method used for diagnosing and monitoring pediatric urolithiasis, with a focus on ruling out conditions like cystinuria and hyperoxaluria, requiring collaboration among pediatric nephrologists, surgeons, and radiologists for effective care.

Article Abstract

The incidence of urolithiasis in children has increased over the two last decades. Urolithiasis formation results from urine oversaturation following insufficient water intake, urinary obstruction (notably in cases of congenital uropathies), excess production of an insoluble compound, or imbalance between crystallization promoters and inhibitors. Whereas most urolithiases in adults occur secondary to environmental factors, in children, secondary causes are far more frequent, and 15% are related to genetic causes, most often monogenic. This is especially true in recurrent forms, with early and rapid progression and bilateral stones, and in cases of familial history or consanguinity. Because of differing clinical management, one should rule out cystinuria, primary hyperoxaluria and renal tubular acidosis, among other causes of urolithiasis. As such, a complete biochemical evaluation must be performed in all cases of pediatric urolithiasis, even in cases of an underlying uropathy. Ultrasound examination is the first-line modality for imaging pediatric urolithiasis, allowing both diagnosis (urolithiasis and its complications) and follow-up. US examination should also explore clues to an underlying cause of urolithiasis. This review is focused on the role of imaging in the management and etiological assessment of pediatric urolithiasis. Radiologists play an important role in pediatric urolithiasis, facilitating diagnosis, follow-up and surgical management. A trio of clinicians (pediatric nephrologist, pediatric surgeon, pediatric radiologist) is thus necessary in the care of these pediatric patients.

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Source
http://dx.doi.org/10.1007/s00247-022-05541-1DOI Listing

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