Ultrasound assessment of the groin in children

Aarushi Gangahar1,2, Kate Kingston1, 1Radiology Department, York Teaching Hospital NHS Foundation Trust, 2Leeds Radiology Academy

The dynamic, real time capabilities of ultrasound are particularly useful in evaluation of the groin region. Our DGH department is receiving an increasing number of requests from paediatricians, ED and GPs for US of the groin, with three main categories of referral: a palpable swelling or lump in groin or scrotum; to answer a specific question in relation to an episode of MSK trauma or to attempt to establish a cause in a child presenting with a limp or non-specific pain.

Although scan technique for the groin is similar in adults and children, the anatomy of the joints and cartilaginous enthyses may be unfamiliar and changes over a relatively short period of time as the cartilage progressively ossifies. Congenital and developmental lesions such as patent processus, undescended or malpositioned testes are more likely to be encountered. Young children may not accurately localise or communicate the site of their symptoms, requiring a greater flexibility of approach. Our pictorial discussion will describe the approach used in our department, focussing on anatomy, probe position and ultrasound technique and how to vary the examination according to the indication in order to examine the hip joint, musculo-tendinous attachments, hernial orifices or palpable lumps. We will show normal anatomy and avulsion injuries, discuss Valsalva techniques and various types of groin hernia and inguinoscrotal developmental abnormalities and how to distinguish them. Space permitting we will include some of the wide spectrum of groin lumps and bumps encountered in a DGH setting.

Ultrasound is excellent for the examination of the groin in children. Scan technique can often be tailored to the specific question being asked, but with young children presenting with non-specific symptoms a more structured approach may be required.

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