Acute penile pathology can not only be confronting for the patient, but also for the sonographer not frequently exposed to acute penile emergencies. In order to confidently contribute to a diagnosis, the sonographer must have an inherent knowledge of the complexities of penile anatomy—namely its facial structure and extensive vascular networks, with dysfunction of either forming the basis of many acute penile diseases. When combined with an understanding of pathophysiological processes, the sonographer can play a pivotal role in influencing management strategies and contribute to achieving favourable patient outcomes. This presentation that serves as an educational tool and suggested guideline in the evaluation of acute penile presentations with ultrasound. It outlines the basic intrinsic requirements relative to B-Mode and Doppler assessment of the penis, optimal scanning techniques and covers the sonographic anatomy of acute penile pathologies encountered in the clinical setting.

This session provides a practical overview of shear wave elastography (SWE) as an emerging tool in prostate imaging. It highlights how quantitative stiffness mapping supports the detection and characterization of prostate lesions, improves biopsy targeting, and complements conventional ultrasound. Key technical considerations, common artefacts, and clinical cases will be discussed, along with current evidence and the evolving role of SWE alongside multiparametric MRI in prostate cancer assessment.

Introduction: Often we encounter patients with acute right iliac fossa (RIF) pain and immediately suspect, “could it be appendicitis?”. Medical imaging stands at the forefront of these investigations, where accurate identification of acute appendicitis is crucial in preventing serious complications. With various other bowel and pelvic pathologies sharing the same symptoms, how can one be confident in reaching a differential diagnosis?
Methods: In this presentation we delve into the clinical background of acute appendicitis including the at-risk demographics and symptoms. We discuss the sonographer’s approach in imaging the RIF and vermiform appendix, and key sonographic features that distinguish between a normal versus inflamed appendix. We also examine a series of case studies and their distinguishing sonographic features; the appendiceal mucocele, intussusception, Crohn’s disease, diverticulitis, mesenteric adenitis, lymphoid hyperplasia, epiploic appendagitis, Amyand hernia, gastrointestinal stromal tumour, endometriosis, ovarian torsion, ovarian follicle rupture and ectopic pregnancy.
Results: There is a significant overlap between said pathologies and acute appendicitis in terms of patient symptoms, regions and relevant anatomy, especially in the female pelvis. Due to its variable position and orientations, isolating the appendix from adjacent structures can also be a challenge in itself.
Conclusion: This highlights the importance of fully visualising a normal appendix before proceeding to rule out other possibilities characterised by the right lower quadrant pain. It is paramount the scan protocol is tailored to ensure out-ruling of appendicitis before progressing on to other possible pathologies, as well as covering the entire abdomen-pelvic region including the RIF, for a comprehensive examination.

Ultrasound is the primary imaging modality for evaluating intratesticular pathology, offering high‑resolution B mode and Doppler assessment that reliably differentiates intra‑ from extra- testicular disease. Most intratesticular masses are hypoechoic and malignant; however, several benign entities may mimic neoplasia. This presentation reviews the sonographic spectrum of common benign lesions—including simple cysts, epidermoid cysts, inflammatory conditions, infarction, and traumatic injuries. Malignant tumours, including seminoma, non-seminomatous germ cell tumours, lymphoma, and leukemia, typically appear as solid hypoechoic masses with variable vascularity, heterogeneous echotexture, and possible calcifications. Understanding the distinct B mode and Doppler signatures of these lesions is essential for accurate diagnosis, guiding timely management, and avoiding unnecessary surgery. Familiarity with these patterns enhances diagnostic confidence and optimizes patient outcomes in the evaluation of scrotal disease.

Male pelvic floor ultrasound is an under-utilised but potentially valuable tool in the assessment of lower urinary tract and defecatory dysfunction. While transabdominal techniques are more commonly described, transperineal ultrasound allows dynamic evaluation of pelvic floor anatomy and function in a manner analogous to female pelvic floor assessment. Key structures that can be assessed include the levator and perineal muscles, urethra and urethral sphincters, bladder base, bulb of penis, and rectum. In this case study it is demonstrated that through dynamic manoeuvres such as contraction and Valsalva, dysfunction of the pelvic floor can be recognised. Ultrasound can also identify structural changes following surgery or in the presence of scarring, strictures, or pelvic floor denervation. While there is still more to learn in this field, this case study highlights that ultrasound can provide useful clinical information.