Objective: To asses role of high frequency ultrasonography and color Doppler in diagnosis of scrotal diseases.

Material and methods: A prospective study of 108 patients who presented with complaints of scrotal pathology and was referred from various clinical departments for ultrasound examination. Prior to examination clinical data and verbal informed consent of patient were obtained. Patients were examined on SAMSUNG ACCUVIX ULTRASOUND Machine with linear array high frequency probe(6–7–9 MHz)  at Department of Radiodiagnosis PDU civil hospital Rajkot from August 2017 to August 2018.

Results:  Highest number of cases were in the age group of 31–40 years (21,19.5%) and minimum in 71–80 years (02,1.8%). Commonest clinical presentation was combination of symptoms like, scrotal swelling and pain as in 26 cases(24%) ,followed by scrotal swelling ,pain and fever in 23 cases(21.2%). The maximum diseases are inflammatory (56,51.8%) followed by inguinoscrotal hernias(13,12%), congenital (9,8.3%). The testicular torsion was present in 4(3.7%) cases. Out of inflammatory pathologies Pyocele(26.7%), Hydrocele(19.6%), Epididymoorchitis while minimum of Epididymitis(1.8%). The echotexture changes in epididymorchitis  were comprised of hypoechoic(50%) changes as well as isoechoic changes(50%). Most of the pyocele were presented with heterogenous echotexture because of multiseptated complex structure. In almost all the cases (100%) of epididymitis and epididymo orchitis and funiculitis the vascularity was highly increased while In testicular torsion vascularity was absent on color Doppler. In testicular neoplasms,non seminomatous germcell tumors were maximum(4,57%) then seminoma and minimum were scrotal wall malignancies(1,14.2%). The nonseminomatous germ cell tumors were hyperechoic, whereas seminomas were predominantly hypoechoic.Present study shows a low sensitivity(76%) and very low specificity(37%) of clinical examination, whereas  high frequency ultrasound is highly sensitive(98%) and specific(100%) in diagnosing scrotal pathologies.

Conclusion: The high frequency ultrasound is highly sensitive and specific as compare to clinical findings in diagnosis of scrotal pathologies and has role in planning for proper management.