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Virtual Pediatric Hospital: MetaTextbook of Pediatric Radiology: Genitourinary System MetaTextbook of Pediatric Radiology

Genitourinary System

Michael P. D'Alessandro M.D.
Peer Review Status: Internally Peer Reviewed

Imaging Modalities | Normal Variants | Kidneys | Adrenal Gland | Bladder, Ureters, Urethra | Male Genital Tracts | Female Genital Tracts

I. Imaging Modalities

| Paediapaedia |

A. Plain radiographs

B. IVU

C. VCUG

D. Retrograde urethrogram

E. Nephrostogram

F. Retrograde ureterogram

G. US

H. CT

I. MR

J. Nuclear medicine

K. Interventional techniques

L. Genitography

II. Normal Variants

A. Embryology | Genitourinary Development |

B. Anatomy | Illustrated Encyclopedia of Human Anatomic Variation |

III. Kidneys

A. Congenital anomalies

1. Ureteropelvic junction obstruction (UPJ) | CERF - 1 | CERF - 2 | CERF - 3 | Loyola U - Genitourinary - IVP | Loyola U - Genitourinary - NM | Loyola U - Genitourinary - OR | Paediapaedia | Paediapaedia - Congenital Hydronephrosis | Pediatric Uroradiology Rounds - Crossing Vessel - 1 | Pediatric Uroradiology Rounds - Crossing Vessel - 2 | Pediatric Uroradiology Rounds - Crossing Vessel - 3 | Pediatric Uroradiology Rounds - Lower Pole | Pediatric Uroradiology Rounds - With Reflux | Rainbow Babies and Children's Hospital |

2. Duplication of renal collecting system | CERF - Duplex Kidney and Ectopic Ureter | Loyola U - Genitourinary | Paediapaedia | Pediatric Uroradiology Rounds - Duplex Kidney and Ectopic Ureter | Pediatric Uroradiology Rounds - Duplex Kidney and Ectopic Ureterocele | Pediatric Uroradiology Rounds - Duplex Kidney and Secondary Obstruction | Pediatric Uroradiology Rounds - Duplex Kidney and Ureterocele | Pediatric Uroradiology Rounds - Duplex Kidney with 4 Anomalies | Rainbow Babies and Children's Hospital | U of Minnesota TF | WebPath |

3. Multicystic dysplastic kidney (MCDK) | BrighamRad | CERF - 1 | CERF - 2 | Loyola U - Genitourinary | Paediapaedia | Pediatric Uroradiology Rounds | Pediatric Uroradiology Rounds - in Lower Pole of Duplex Kidney | Pediatric Uroradiology Rounds - With Ureterocele | U of North Carolina | WebPath - 1 | WebPath - 2 | WebPath - 3 | WebPath - 4 |

4. Agenesis, renal | Children's Hospital, Birmingham | Pediatric Uroradiology Rounds | WebPath - 1 | WebPath - 2 |

5. Hypoplasia, renal

6. Ectopia | CERF | Loyola U - Genitourinary | Pediatric Uroradiology Rounds | Thoracopaedia |
a. Ptosis, renal

b. Pelvic kidney | CERF - 1 | CERF - 2 | CERF - 3 | CERF - Horseshoe - 1 | CERF - Horseshoe - 2 | CERF - Horseshoe - 3 | Paediapaedia - Horseshoe | Pediatric Uroradiology Rounds - Horseshoe | Radiology Central Resource - Horseshoe | WebPath - Horseshoe |

c. Crossed ectopia | Paediapaedia |

7. Relationship of congenital renal anomalies with other congenital anomalies (i.e., VATER association, spinal dysraphism, etc.) | Pediatric Uroradiology Rounds - Ectopic Ureter Causing Orchitis |

8. Cystic renal disease | WebPath |
a. Autosomal recessive polycystic kidney disease (ARPCKD) | CERF | Paediapaedia | U of North Carolina | WebPath - 1 | WebPath - 2 | WebPath - 3 | WebPath - 4 | WebPath - 5 |

b. Autosomal dominant polycystic kidney disease (ADPCKD) | CERF - 1 | CERF - 2 | Paediapaedia | WebPath - 1 | WebPath - 2 | WebPath - 3 | WebPath - 4 | WebPath - 5 |

c. Cysts associated with malformation syndromes | U of Pittsburgh Pathology - Renal Tubular Dysgenesis |

B. Inflammatory

1. Acute pyelonephritis | Chiang Mai U - Renal Abscess | Pediatric Uroradiology Rounds | WebPath - 1 | WebPath - 2 | WebPath - Renal Abscess |

2. Reflux nephropathy | CERF |

C. Neoplasms

1. Wilms tumor and Wilms variant | CERF - 1 | CERF - 2 | CERF - 3 | CERF - 4 | CERF - 5 | CERF - 6 | CERF - 7 | CERF - 8 | CERF - 9 | CERF - 10 | CERF - 11 | CERF - Bilateral | Correlapaedia | Loyola U - Genitourinary | Paediapaedia | Radiology Central Resource | Rainbow Babies and Children's Hospital | WebPath - 1 | WebPath - 2 | WebPath - 3 |

2. Nephrogenic rests

3. Mesoblastic nephroma | BrighamRad - 1 | BrighamRad - 2 | BrighamRad - 3 | CERF | Correlapaedia | Paediapaedia |

4. Multilocular cystic nephroma (MLCN) |

5. Leukemia / lymphoma, renal | Chiang Mai U - Non Hodgkins | Paediapaedia - Burkitt |

D. Trauma

1. Subcapsular hematoma, renal

2. Laceration, renal (including those communicating with the collecting system) | CERF | Paediapaedia |

3. Contusion, renal | CERF |

4. Avulsion of the renal pedicle | CERF - 1 | CERF - 2 |

5. Ureteropelvic junction avulsion or laceration | Children's Hospital, Birmingham |

E. Miscellaneous

1. Renal vein thrombosis (RVT)

2. Urolithiasis / nephrocalcinosis
Nephrocalcinosis | CERF - Nephrocalcinosis | Chiang Mai U | Pediatric Uroradiology Rounds - Nephrocalcinosis | Rainbow Babies and Children's Hospital - Nephrocalcinosis | U of North Carolina |

Renal calculi | CERF | Pediatric Uroradiology Rounds - Immobilization Stone - 1 |

Ureteral calculi | CERF - Ureteral Calculi - 1 | CERF - Ureteral Calculi - 2 | Pediatric Uroradiology Rounds - Fraley's Syndrome | Pediatric Uroradiology Rounds - Bilateral |

3. Renal transplant

4. Renovascular hypertension (HTN) | CERF | Pediatric Uroradiology Rounds - Fibromuscular Dysplasia |

IV. Adrenal Gland

A. Neoplasms

1. Neuroblastoma, abdominal | Catholic University of Korea - Presacral | CERF - 1 | CERF - 2 | CERF - 3 | CERF - 4 | CERF - 5 | CERF - 6 | CERF - 7 | CERF - 8 | CERF - 9 | CERF - 10 | CERF - 11 | CERF - 12 | CERF - Pelvic - 1 | CERF - Pelvic - 2 | Chiang Mai U - Overview | Correlapaedia - Presacral | Paediapaedia | Rainbow Babies and Children's Hospital | WebPath-1 | WebPath-2 | Virtual Pediatric Patients | (See also Chest and Airway IV. C. 1. d.)

B. Trauma, adrenal

1. Adrenal hemorrhage and calcification | CERF - 1 | CERF - 2 | Paediapaedia |

V. Bladder, Ureters, and Urethra

A. Congenital

1. Posterior urethral valves (PUV) | BrighamRad | CERF - Bladder Stone | Loyola U - Genitourinary | Paediapaedia | Pediatric Uroradiology Rounds - 1 | Pediatric Uroradiology Rounds - 2 | Pediatric Uroradiology Rounds - 3 | Rainbow Babies and Children's Hospital |

2. Ureterovesical junction obstruction (UVJ) | Pediatric Uroradiology Rounds - Duplex Kidney with 4 Anomalies | Pediatric Uroradiology Rounds - Ureteral Valve |

3. Primary megaureter | CERF - 1 | CERF - 2 | Loyola U - Genitourinary | Pediatric Uroradiology Rounds | Pediatric Uroradiology Rounds - Megaureter - Megacystis | Pediatric Uroradiology Rounds - Spontaneous Improvement |

4. Bladder diverticuli | CERF | CERF - Hutch | Loyola U - Genitourinary | Pediatric Uroradiology Rounds - Dysfunction Due to Bladder Diverticula | Pediatric Uroradiology Rounds - Multiple | Pediatric Uroradiology Rounds - Single |

5. Ureteral duplication | Loyola U - Genitourinary | Pediatric Uroradiology Rounds - Ectopic Ureter | Pediatric Uroradiology Rounds - Ectopic Ureter and Ectopic Ureterocele | Pediatric Urology Rounds - Ectopic Ureter in a Girl With Continuous Urinary Dribbling | Pediatric Uroradiology Rounds - Obstructed Ectopic Ureter | Pediatric Uroradiology Rounds - Refluxing Ectopic Ureter | Pediatric Uroradiology Rounds - Single System Ectopic Ureter | Pediatric Uroradiology Rounds - Triplication | Rainbow Babies and Children's Hospital |

6. Ureterocele | Catholic University of Korea | CERF - 1 | CERF - 2 | CERF - Ectopic | CERF - Ectopic and Duplex Kidney - 1 | CERF - Ectopic and Duplex Kidney - 2 | CERF - Ectopic and Duplex Kidney - 3 | Loyola U - Genitourinary | Pediatric Uroradiology Rounds - Disproportion - 1 | Pediatric Uroradiology Rounds - Disproportion - 2 | Pediatric Uroradiology Rounds - Ectopic - 1 | Pediatric Uroradiology Rounds - Ectopic - 2 | Pediatric Uroradiology Rounds - Ectopic Ureter Causing Orchitis | Pediatric Uroradiology Rounds - Ectopic in Utero | Pediatric Uroradiology Rounds - Mimic | Pediatric Uroradiology Rounds - Mimic of Bladder | Pediatric Uroradiology Rounds - Prolapse | Pediatric Uroradiology Rounds - Single System | Pediatric Uroradiology Rounds - Stenotic Ectopic | Paediapaedia |

7. Urachal abnormalities | Children's Hospital, Birmingham | Loyola U - Genitourinary |

8. Hypospadias | Loyola U - Genitourinary |

9. Epispadias / exstrophy | Loyola U - Genitourinary - Exstrophy | Paediapaedia - Exstrophy | Pediatric Uroradiology Rounds - Epispadias | Pediatric Uroradiology Rounds - Exstrophy - Bladder Stone |

10. Prune belly syndrome | CERF - 1 | CERF - 2 | Paediapaedia |

11. Urologic sequelae of ano-rectal anomalies | CERF - 1 | CERF - 2 | Pediatric Uroradiology Rounds - Meconium Peritonitis |

B. Inflammatory / infectious

1. Urinary tract infection (See above - Acute Pyelonephritis III. B. 1 or below - Vesicoureteral reflux V. D. 1.)

2. Cystitis, viral | Pediatric Uroradiology Rounds - Eosinophillic Cystitis |

C. Neoplasms

1. Rhabdomyosarcoma, bladder | BrighamRad - Prostate | CERF - Bladder | Correlapaedia - Bladder | Paediapaedia - Bladder |

D. Miscellaneous

1. Vesicoureteral reflux (VUR) | Catholic University of Korea | CERF - 1 | CERF - 2 | CERF - 3 | Loyola U - Genitourinary | Paediapaedia | Pediatric Uroradiology Rounds | Pediatric Uroradiology Rounds - Bilateral Lower Pole | Pediatric Uroradiology Rounds - Bilateral Lower Pole with Upper Pole Hydronephrosis | Pediatric Uroradiology Rounds - Bilateral Severe | Pediatric Uroradiology Rounds - Ectopic Ureterocele | Pediatric Uroradiology Rounds - Intrarenal Reflux | Pediatric Uroradiology Rounds - Not Posterior Urethral Valves | Pediatric Uroradiology Rounds - Reflux on Ultrasound | Pediatric Uroradiology Rounds - Transient Renal Tubular Unresponsiveness | Pediatric Uroradiology Rounds - Vaginal Reflux |

2. Neurogenic bladder (NGB)

3. Dysfunctional voiding | Pediatric Uroradiology Rounds - Dysfunction Due to Bladder Diverticula |

VI. Male Genital Tracts

A. Testicular torsion | Loyola U - Genitourinary - Bell Clapper Deformity | Loyola U - Genitourinary - Torsion of Appendix Testis | Loyola U - Genitourinary - Torsion of Testis | WebPath |

B. Inflammatory / infectious

1. Epididymitis / orchitis | Pediatric Uroradiology Rounds - Ectopic Ureter Causing Orchitis |

C. Neoplasms

1. Germ cell tumor, testicular | Radiology Central Resource | WebPath - Seminoma - 1 | WebPath - Seminoma - 2 | WebPath - Seminoma - 3 | WebPath - Seminoma - 4 | WebPath - Seminoma - 5 | WebPath - Embryonal - 1 | WebPath - Embryonal - 2 | WebPath - Endodermal Sinus |

2. Germ cell plus stromal cell tumor, testicular | WebPath - Embryonal / Teratoma - 1 | WebPath - Embryonal / Teratoma - 2 | WebPath - Embryonal / Teratoma - 3 | WebPath - Embryonal / Teratoma - 4 | WebPath - Embryonal / Teratoma - 5 |

3. Gonadal stromal tumor, testicular | Rainbow Babies and Children's Hospital |

VII. Female Genital Tracts

A. Congenital

1. Congenital vaginal occlusion (Hydrometrocolpos, etc.) | Paediapaedia | Pediatric Uroradiology Rounds | U of Hawaii | U of North Carolina |

2. Fusion anomalies of the mullerian ducts (Uterus didelphys, etc.) | CERF - Uterus Didelphys | WebPath - Uterus Didelphys |

3. Cloacal anomalies | Correlapaedia - Cloacal Malformation | Loyola U - Genitourinary - Cloacal Exstrophy | Pediatric Uroradiology Rounds - Urogenital Sinus Anomaly | Rainbow Babies and Children's Hospital |

B. Neoplasms

1. Ovaries
a. Ovarian cysts (including torsion) | CERF | Correlapaedia | Rainbow Babies and Children's Hospital - Parovarian | WebPath - Corpus Luteum Cyst | WebPath - Corpus Luteum Cyst Hemorrhagic - 1 | WebPath - Corpus Luteum Cyst Hemorrhagic - 2 | WebPath - Follicular Cyst | WebPath - Torsion |

b. Germ cell tumor, ovarian | CERF - Dermoid - 1 | CERF - Dermoid - 2 | CERF - Teratoma | Correlapaedia - 1 | Correlapaedia - 2 | Paediapaedia - 1 | Paediapaedia - 2 | WebPath - Dysgerminoma | WebPath - Teratoma - 1 | WebPath - Teratoma - 2 | WebPath - Teratoma - 3 |

2. Uterus and vagina
a. Rhabdomyosarcoma, uterine

b. Clear cell adenocarcinoma, uterine

C. Miscellaneous

1. Differential diagnosis of intralabial masses
a. Prolapsing ectopic ureterocele

b. Obstructed paraurethral gland

c. Imperforate hymen with hydrometrocolpos (See above VII. A. 1.)

d. Urethral prolapse

e. Sarcoma botryoides

2. Intersex states
a. Differential diagnosis | Rainbow Babies and Children's Hospital - Congenital Adrenal Hyperplasia |

b. Work-up

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