In the adult population, radiographic evaluation is required in patients with hypotension, penetrating injuries in the vicinity of urologic organs, associated abdominal injuries, or the presence of any degree of hematuria Criteria regarding the imaging of children with penetrating trauma are less well established Hypotension is not a reliable indicator of significant renal injury in children and therefore is not used to guide management; however, most patients with multisystem trauma and hypotension undergo an abdominal computed tomographic (CT) scan screening that elucidates both nonurologic and urologic injuries Radiographic evaluation of the pediatric genitourinary tract is necessary in cases with clinical signs indicative of renal injury, gross hematuria, major associated injuries, or history of significant deceleration forces For blunt abdominal trauma, imaging is considered in any stable child with gross hematuria or significant microscopic hematuria (>50 red blood cells per high power field) associated with shock (systolic blood pressure 50 red blood cells with or without shock Additionally, any child with a significant associated injury or a suspicious mechanism of injury such as a rapid deceleration, high velocity strike, fall from >15 ft, or a direct blow to the abdomen or flank should be imaged regardless of the presence of hematuria All clinically stable children with penetrating abdominal or pelvic trauma should undergo radiographic assessment Stable blunt trauma patients with microscopic hematuria may be observed without imaging, unless they suffered a major acceleration or deceleration injury such as a fall from a great height or high-speed MVC