A voiding cystourethrogram in a 3-year-old girl shows reflux into a moderately dilated and tortuous ureter with blunting of the calyceal fornices but preservation of the papillary impressions. According to the international grading system, this corresponds to which grade of vesicoureteral reflux?
- A Grade II
- B Grade III
- C Grade IV ✓
- D Grade V
Correct answer: C. Grade IV
Explanation
Grade IV reflux shows moderate dilatation and tortuosity of the ureter with complete blunting of the fornices but the papillary impressions remain visible. Grade III has only mild to moderate ureteral dilatation with partial forniceal blunting and preserved papillae. Grade V adds gross ballooning, severe tortuosity and loss of the papillary impressions, so that finding excludes grade V here.
Reference: Campbell-Walsh Urology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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