photon-deficient lesion without preservation of reniform shape.

photon-intense lesion without preservation of reniform shape.

photon-intense lesion with normal reniform shape preserved.

photon-deficient lesion located centrally.

photon-deficient lesion with normal reniform shape preserved.

MAG-3 diuretic renography

repeat ultrasonography.

computed tomographic (CT) urogram.

intravenous pyelogram (IVP).

retrograde pyelogram.

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).

call for ultrasonography to come in to confirm torsion.

take him immediately for surgical exploration.

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

Collecting tubule

Thin segment loop of Henle

Proximal tubule

Distal tubule

Glomerulus

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.

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

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.