Cross sectional imaging findings of testicular trauma

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What cross sectional imaging findings may be encountered in testicular trauma?

Testicular trauma is most often secondary to blunt trauma, usually in the setting of a sports-related injury. Cross-sectional imaging findings of testicular trauma may include testicular contusion, hematoma, laceration/fracture, rupture, infarction, dislocation, and avulsion. Ancillary imaging findings may include hydrocele, hematocele (hemorrhage within the scrotum adjacent to the testicle located between the visceral and parietal layers of the tunica vaginalis), soft tissue hematoma, scrotal laceration, and post-traumatic epididymitis.

Testicular rupture occurs when there is disruption of the tunica albuginea with associated extrusion of testicular parenchyma. When testicular rupture has occurred, this is considered to be a surgical emergency. US imaging features of testicular rupture include a linear hypoechoic focus in the testicle (representing a laceration/fracture), discontinuity of the tunica albuginea, an ill-defined testicular contour, and a bulge along the testicular contour. Associated findings of testicular hematoma and infarction are also commonly seen. If surgery is performed within 3 days of injury, up to 90% of injured testicles can be salvaged.

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