Pediatric Scrotolith

  • Etiology: May represent calcified loose bodies from prior torsion of the appendix testis or may represent reactive fibrous proliferation from microtrauma causing intrascrotal inflammation in bikers
  • Imaging US:
    — Mobile hyperechoic lesion that is in the scrotum but is extratesticular in location in potential tunica vaginalis space
    — Large lesions can have posterior acoustical shadowing
    — If there is a hydrocele the lesion may be free floating
  • DDX:
  • Complications:
  • Treatment: None
  • Clinical:
    — Usually asymptomatic and of no clinical significance
    — Also known as scrotal pearls

Radiology Cases of Scrotolith

US of scrotolith
Transverse (above) and sagittal (below) US of the left scrotum show an oval hyperechoic lesion that is in the scrotum but that is extratesticular in location and which has posterior acoustical shadowing.
US of scrotolith
Sagittal US of the right scrotum shows a round echogenic extratesticular lesion that does not have posterior shadowing in the superior and posterior scrotum.