Spectrum of Testicular Findings on High-Resolution Ultrasonography in Children: A Cross-Sectional Study of 495 Patients

Abstract

Background: Ultrasonography (USG) is the primary imaging modality for the evaluation of scrotal and testicular abnormalities in children. With advances in high-resolution ultrasonography, detailed assessment of congenital, inflammatory, traumatic, vascular, and neoplastic conditions has become possible, facilitating timely diagnosis and appropriate clinical management.
Objective: To evaluate the spectrum and distribution of testicular and extratesticular abnormalities detected by high-resolution
ultrasonography in pediatric patients.
Patients and Methods: This cross-sectional study included 495 pediatric patients, ranging from neonates to 18 years of age, who were referred for scrotal ultrasonography because of pain, swelling, trauma, or suspected developmental abnormalities. High-resolution ultrasonography was performed using a 7.5–12 MHz linear transducer. Sonographic findings were categorized into congenital, inflammatory, traumatic, vascular, and neoplastic abnormalities. Descriptive statistics were used to determine the frequency and distribution of individual pathologies.
Results: Of the 495 patients evaluated, 58.9% had normal ultrasonographic findings, while 41.1% demonstrated testicular or extratesticular abnormalities. The most frequently identified abnormalities were hydrocele (22.4%), cryptorchidism (14.6%), epididymo-orchitis (12.5%), varicocele (9.4%), testicular torsion (6.3%), testicular microlithiasis (5.2%), traumatic lesions (4.2%), and neoplastic lesions (2.1%). High-resolution ultrasonography enabled detailed characterization of the type, laterality, and extent of the detected abnormalities.
Conclusion: High-resolution ultrasonography demonstrated a broad spectrum of testicular and extratesticular abnormalities in pediatric patients, with hydrocele and cryptorchidism being the most frequently encountered conditions. The findings support the role of ultrasonography as a safe, accessible, and effective first-line imaging modality for the evaluation of pediatric scrotal disorders.

BJusg. vol. 27, no. 1, June 2026, Page: 26-32