Role of US in testicular and scrotal trauma

High-frequency ultrasonography (US) with a linear-array transducer is the modality of choice for the initial evaluation of patients with acute scrotal pain after trauma. Testicular trauma is the third most common cause of acute scrotal pain. US is useful in the triage of patients for medical or surgical management because it reliably depicts tunica albuginea rupture, intra- and extratesticular hematomas, and testicular contusions. Color Doppler US allows direct evaluation of testicular perfusion and detection of uncommon conditions, such as testicular torsion, that may be associated with scrotal trauma. In addition, 10% of testicular tumors are found incidentally at US performed for the evaluation of trauma. If a conservative approach is adopted for the management of an intratesticular abnormality after trauma, follow-up US should be performed until the images show a complete resolution of the abnormality, so that a tumor will not be missed.