Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

13. Imaging for Evaluation of Groin Pain
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Fig. 13.17. Transverse US and Doppler US of a complex ovarian cyst with
large central septation ( large white arrow ), an ovary with numerous large thinwalled
theca lutein cysts ( white arrows ) in follicular hyperstimulation, and a
normal corpus luteum cyst surrounded by its pathognomic “ring of fire”
( curved white arrow ) of peripheral increased vascularity.
Fig. 13.18. Sagittal Doppler US images. Normal testicle has homogenous
echotexture and scattered vascularity ( white arrows ). By contrast, testicular lymphoma
presents as an ill-defined, hypoechoic focus ( large white arrow ) with significant
hypervascularity ( curved white arrows ). Scrotal hematoma can also
appear irregular and heterogenous, but should not demonstrate internal vascularity.
Fig. 13.19. Bilateral sagittal US and Doppler US images through the epididymis
comparing the enlarged, hypoechoic, and hypervascular ( curved white arrows )
appearance of epididymitis with the normal contralateral anatomy.
mon causes of groin pain, which often elevates it as a first-line mode of
evaluation, particularly when genitourinary pathologies are suspected.
US is often a definitive examination for groin pain due to ovarian and
testicular masses or torsion, ectopic pregnancy, uterine fibroids,
epididymo- orchitis, pelvic inflammatory disease, hydrocele, varicocele,
and pelvic congestion (Figs. 13.17 , 13.18 , and 13.19 ).
US also has numerous applications in the initial evaluation of musculoskeletal
pathologies, though it may not be definitive. Pathologies such