Despite the fact that the urology literature has indicated that the use of ultrasound for diagnosis of cryptorchidism delays diagnosis and management of this disorder, the practice continues. This is why Kanaroglou et al. (doi: 10.1542/peds.2015-0222) decided to provide strong evidence against the use of ultrasound as the gold standard of diagnosis for undescended testicle by reviewing the records of boys between 0 and 18 years in Ontario using administrative data as well health records. The authors looked at to the frequency of ultrasound use as well as time delays between diagnosis and surgical management in those patients who did and did not have ultrasound.
Despite the problems using ultrasound to make the diagnosis, sadly in this study the trend to use this modality increased over time resulting in a 3-month delay on average in making the definitive diagnosis and in turn treatment using surgical repair. So who is still ordering ultrasounds when the clinical diagnosis raises suspicion?
Read this article and then tack down what you learn so that ultrasound is not ordered, but a urological or surgical referral is when you suspect your patient has an undescended testicle.