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The Large Pediatric Scrotum: Ultrasound Technique and Differential Considerations

Schmitz, Kelli MD*; Snyder, Kathryn MD; Geldermann, David; Sohaey, Roya MD

doi: 10.1097/RUQ.0000000000000053
Pictorial Essay

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.

*Diagnostic Radiology, Oregon Health & Science University/Doernbecher Children’s Hospital, Portland, OR; †Diagnostic Radiology, Oregon Health & Science University, Portland, OR; and ‡Colgate University, Hamilton, NY.

Received for publication July 31, 2013; accepted October 9, 2013.

The authors declare no conflict of interest.

Presented as an electronic educational exhibit at the American Institute of Ultrasound in Medicine 2013 Annual Meeting (recipient of Honorable Mention).

Reprints: Kelli Schmitz, MD, Diagnostic Radiology, Oregon Health & Science University/Doernbecher Children’s Hospital, 3181 SW Sam Jackson Park Rd, DC7R Portland, OR 97239 (e-mail:

© 2014 by Lippincott Williams & Wilkins