Ultrasound evaluation of scrotal pathology

Palpable scrotal mass, acute scrotal pain, and enlarged scrotum are common scenarios in clinical practice. The imaging modality of choice to evaluate scrotal pathology is ultrasound (US). US is key in determining if a palpable abnormality is extratesticular or intratesticular and cystic or solid. US findings help narrow the differential to benign or malignant causes. Extratesticular lesions are more common and usually benign. Rarely, extratesticular solid lesions are malignant but US features are nonspecific. Accurately diagnosing rare benign intratesticular lesions is vital to avoid unnecessary orchiectomy. This article reviews extratesticular and intratesticular lesions presenting as a palpable mass and other conditions commonly seen.