The sonographic features were reviewed in 30 cases of testicular trauma. Sonography correctly diagnosed testicular rupture in 12 surgically proven cases. Two additional cases of testicular rupture were diagnosed by sonography in patients who refused surgery. One false-positive diagnosis occurred in a patient with a large scrotal hematoma. There were no known false-negative diagnoses. Discrete fracture planes often are not identified by sonography in cases of testicular rupture. However, any alteration of the normal testicular echogenicity in traumatized patients suggests testicular rupture and requires surgery.
