In Reply.—The excretory urograms of all five cases were reviewed and discussed with pediatric radiologists in the Department of Pediatric Radiology, University of British Columbia, Vancouver. Representative photographs from each urogram were supplied to the editors. Unfortunately, during revision, the legend to the figure was incorrectly transcribed by the authors, and the correct legend should have read "This patient has bilateral papillary necrosis, an example of which is shown in the upper pole of the right kidney."
We agree with Dr Bowen that the diagnosis of RPN is a radiologic diagnosis. We are confident that the quality of the excretory urograms and the interpretation by the radiologists is adequate to support the diagnosis in each case.