MyPACS.net: Radiology Teaching Files > Case 34816910

Never visited KNEE TO THE GROIN
Contributed by: Baxter Tharin, Resident, Wilford Hall Medical Center, Texas, USA.
Patient: 18 year old male
History: 18 year old male: with blunt trauma (knee to the groin) during hand-to-hand combat drills.  Pt presented 3 days after injury.
Images:[small]larger

Fig. 1

Fig. 2

Fig. 3: gross specimen

Fig. 4: gross specimen, bivalved in a sagittal plane
Findings: There is heterogenous appearance of the left testis parenchyma, enlargement of vessels, and disruption of the tunica albuginea.
Diagnosis: Fractured testis.
Discussion:

After truama, there are three clinical questions:

First -- is the tunica albuginea is in tact?  If so, then surgery is usually not required.  If disrupted, then surgery is required within 72 hours in order to preserve the testis.  In this case, given the findings and that the patient was outside of the 72-hour window, an orchectomy was performed (see images of gross specimen).

Second -- do abnormal findings represent a neoplasm? Trauma can also prompt a patient to palpate a previously undetected mass which may represent a tumor. 

Third -- is there torsion?  Trauma can induce testicular torsion. 

References: The Requisites, Ultrasound. 2nd Ed, Mosby. Middleton, Kurtz, Hertzberg.
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Additional Details:

Case Number: 34816910Last Updated: 2011-08-04
Anatomy: Genitourinary (GU)   Pathology: Trauma
Modality: USAccess Level: Readable by all users

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