Top down approach in the evaluation of the child with a history of UTI

What is the top down approach in the evaluation of the child with a history of UTI?

The “top-down approach” refers to a protocol that more selectively identifies children with history of UTI who may require voiding cystography. In these patients, rather than having a VCUG performed initially, VCUG is obtained based on whether an initial renal cortical scintigraphic study is normal or abnormal.

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