A 7-Year-Old Boy Is Brought to the Office Due to Urinary

A 7-year-old boy is brought to the office due to urinary dribbling for the past 2 months.  Symptoms occur during the day as well as overnight.  Review of systems is positive for chronic constipation.  He has no other chronic medical problems and takes no medications.  Temperature is 37.2 C (99 F) , blood pressure is 100/60 mm Hg, pulse is 80/min, and respirations are 16/min.  Growth parameters are normal.  Physical examination shows a tuft of hair above the gluteal cleft and is otherwise normal.  Urinalysis is normal.  Which is the most appropriate next step in management of this patient?

A) Abdominal ultrasound
B) Abdominal x-ray
C) Measurement of 24-hour urine volume
D) MRI of the spine
E) Reassurance and laxatives

Correct Answer:

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