Acute Painful Scrotum

The acute painful scrotum, which is the most common urologic emergency, may present a diagnostic challenge even to experienced clinicians. Imaging is used mainly to identify patients requiring surgical treatment to reduce the rate of unnecessary testicular exploration. Gray-scale ultrasound combined with color and pulsed Doppler modes is the method of choice for patients presenting with acute scrotal pain. This article describes the ultrasound features of scrotal pathologies associated with a painful scrotum and the pitfalls of a relevant scrotal ultrasound examination.