The primary causes of scrotal trauma are blunt, penetrating, degloving, and electrical burn injuries to scrotal contents. Knowledge of the scrotal anatomy and appropriate imaging techniques are key for accurate evaluation of scrotal injuries. Ultrasonography (US) is the first-line imaging modality to help guide therapy for scrotal trauma, except in degloving injury, which results in scrotal skin avulsion. Blunt injury (eg, from an athletic accident or motor vehicle collision) is the most common cause of scrotal trauma, followed by penetrating injury from gunshot or other assault. Trauma often may result in hematoma, hydrocele, hematocele, testicular fracture, or testicular rupture. The timely diagnosis of rupture, based on a US finding of discontinuity of the echogenic tunica albuginea, is critical because emergent surgery results in salvage of the testis in 80%-90% of rupture cases. The radiologist should be familiar also with other nuances associated with penetrating trauma, iatrogenic and postoperative complications, and electrical injury. Color flow and duplex Doppler imaging are highly useful techniques not only for assessing testicular viability and perfusion but also for evaluating associated vascular injuries such as pseudoaneurysms. A thorough familiarity with the US findings of scrotal trauma helps facilitate appropriate management. Supplemental material available at radiographics.rsnajnls.org/cgi/content/full/27/2/357/DC1.

Sixty-nine percent of benign nodules had at least 1 finding reported previously as associated with malignancy. The interobserver reliability of the sonographic findings was good to very good for 3 of the 5 findings assessed.

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A prospective study was designed to assess the accuracy of gray scale ultrasonography in the evaluation of cholelithiasis. A series of 111 patients with nonvisualization on first-day oral cholecystography underwent ultrasonic cholecystography, and the results were compared with subsequent second-day visualitzation or surgical findings. In 75 cases sufficient data were present to assess the accuracy of the method. Ultrasound correctly diagnosed 68 (91%) of these cases with regard to gallstones. Only 6 gallbladders could not be visualized ultrasonically and all subsequently proved to have gallstones. It is concluded that improved ultrasonic technique is of considerable value in investigating the nonvisualized gallbladder. Valuable information conderning other upper abdominal pathology was often discovered.

Neonatal adrenal hemorrhage can be diagnosed with a combination of ultrasound and excretory urography without resorting to surgical exploration or invasive diagnostic procedures. The radiologic findings of adrenal hemorrhage on excretory urography include downward displacement of the kidney on the affected side and a radiolucent suprarenal mass on the body nephrogram phase. Ultrasound studies reveal a sonolucent suprarenal mass. Four cases of varying degrees of adrenal hemorrhage are presented together with the radiographic and sonographic findings.