The large pediatric scrotum: ultrasound technique and differential considerations

Scrotal enlargement in the pediatric population is caused by a variety of pathologic processes including hydroceles, hernias, varicoceles, testicular torsion, testicular or paratesticular infection, trauma, or neoplasm; adrenal rests; or scrotal skin edema. The clinical presentation of scrotal enlargement is often nonspecific, and ultrasound plays a key role in making the correct diagnosis. In this pictorial review, we review the ultrasound protocol for performing scrotal ultrasound in pediatric patients and illustrate the ultrasound appearance of conditions resulting in scrotal enlargement.