photon-deficient lesion without preservation of reniform shape.

photon-deficient lesion located centrally.

photon-intense lesion without preservation of reniform shape.

photon-deficient lesion with normal reniform shape preserved.

photon-intense lesion with normal reniform shape preserved.

retrograde pyelogram.

MAG-3 diuretic renography

intravenous pyelogram (IVP).

repeat ultrasonography.

computed tomographic (CT) urogram.

take him immediately for surgical exploration.

obtain urinalysis, treat empirically with antibiotics, and send home with narcotic pain meds.

call for ultrasonography to come in to confirm torsion.

obtain testicular scintigraphy to differentiate between torsion and an inflammatory process.

reassure the patient this is likely epididymitis and give a trial of nonsteroidal anti-inflammatory drugs (NSAIDs).

Collecting tubule

Proximal tubule

Glomerulus

Distal tubule

Thin segment loop of Henle

have the child return in 6 months for repeat examination and consider hormonal therapy to encourage spontaneous descent.

obtain a scrotal/pelvic ultrasound to determine the presence and/or location of the nonpalpable gonad.

proceed to surgical exploration for cryptorchidism without further imaging.

obtain pelvic magnetic resonance imaging (MRI) to determine the presence and/or location of the nonpalpable gonad.

obtain testicular scintigraphy to determine the presence and/or location of the nonpalpable gonad.