Sagittal US of the kidneys (above) show small echogenic kidneys bilaterally with some cysts but no hydronephrosis. AP image from a VCUG (below left) shows bilateral grade 4 vesicoureteral reflux with intrarenal reflux and the bladder is trabeculated. Lateral image from the VCUG (below right) shows a urachal diverticulum arising from the dome of the bladder anteriorly. The urethra was normal.