DDX of scrotal mass

Approach to the DDX of scrotal mass:

  • US is the first step in imaging
  • An undescended testicle may make the contralateral side appear mass-like
  • A cystic mass is most likely a hydrocele
  • Inguinal hernias are diagnosed by observing bowel peristalsis, incarceration of an inguinal hernia cannot be diagnosed on US
  • When assessing testicular trauma, assess the viability of the testicle
  • Testicular torsion should be ruled out in all cases
  • A solid testicular mass is a tumor until proven otherwise
  • Varicocele has a classic serpiginous appearance