photon-intense lesion with normal reniform shape preserved.

photon-deficient lesion located centrally.

photon-deficient lesion without preservation of reniform shape.

photon-deficient lesion with normal reniform shape preserved.

photon-intense lesion without preservation of reniform shape.

intravenous pyelogram (IVP).

computed tomographic (CT) urogram.

repeat ultrasonography.

MAG-3 diuretic renography

retrograde pyelogram.

take him immediately for surgical exploration.

call for ultrasonography to come in to confirm torsion.

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

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

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

Proximal tubule

Thin segment loop of Henle

Distal tubule

Collecting tubule

Glomerulus

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

proceed to surgical exploration for cryptorchidism without further imaging.

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

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

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