The optimal imaging strategy for febrile urinary tract infections in children is not yet satisfactorily defined, mainly because of the different clinical scenarios in which these acute illnesses are framed. This is overall true for radionuclide imaging, whose well-known advantages and weaknesses have a weight that can change according to the characteristic of the patients (age, sex, anatomical features, and clinical history). Cortical renal scan with 99mTc-dimercaptosuccinic acid, direct radionuclide cystography, and dynamic renal scan with MAG3 plus indirect radionuclide cystography should be ever taken into account whenever doubts arose during clinical evaluation, mainly looking for their right use in the right child at the right time, having the necessary flexibility in applying published guidelines, being aware of the debate still running about.
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