Heterogeneous testicular parenchyma or contour abnormality of testis in setting of scrotal trauma

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  Disruption of tunica albuginea very specific for testicular rupture

Extratesticular hematocele: Most common finding in scrotum after blunt injury

US appearance of hematoma depends on time elapsed since trauma

Intra- or extratesticular air in scrotum, missile track &/or foreign bodies (bullet/pellet) indicative of penetrating injury

Spermatic cord hematoma appears as heterogeneous, avascular mass superior to testis

Color Doppler useful to determine viable portions of testis

Sports injuries (> 50%), vehicular and ballistic trauma, and iatrogenic

Unless repaired within 72 hours, salvage rate only 45%

Follow-up of conservatively treated testicular hematomas essential due to increased risk of infection, which may result in orchiectomy

Orchiectomy (total or partial) performed for nonviable testis in testicular rupture

Surgical exploration and drainage must be performed for large, intratesticular hematomas

Tumors may be discovered after trauma; consider tumor if internal color flow in intratesticular lesion

Focal disruption of tunica albuginea = testicular rupture in setting of trauma