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The development of color-flow imaging has made ultrasound the primary imaging modality for the evaluation of testicular pathology. The ability to distinguish between epididymo-orchitis and torsion is of great clinical significance in those patients with acute onset of pain. Not only does the appropriate treatment depend on the correct diagnosis, but the outcome following that treatment is also dependent on establishment of the diagnosis. Although it is of less importance in the evaluation of testicular neoplasms, color-flow imaging does provide adjunctive information that can aid in establishment of the proper diagnosis in confusing clinical situations. The diagnosis of varicocele depends on color-flow imaging, and the prediction of testicular viability following trauma is essential for proper treatment. More studies concerning the use of power Doppler for imaging of scrotal disorders are necessary to determine what its role will be.

Sonography is a widely used modality for the evaluation of both native and transplanted kidneys. It is noninvasive, portable, and requires minimal patient preparation. Renal sonography can estimate kidney size, determine the presence or absence of hydronephrosis, and the presence and characteristics of any intrarenal or extrarenal masses. The addition of color, and, more recently, power Doppler have enhanced the diagnostic capabilities of renal sonography. Color and power Doppler have distinct but complementary uses, and knowledge of the advantages and limitations of each are essential for proper application of these powerful tools. The differences between color and power Doppler is discussed, with emphasis on their relative strengths. Clinical uses of color Doppler include the evaluation of perfusion abnormalities, renal artery stenosis, renal vein thrombosis, pseudoaneurysms, and arteriovenous fistulas. Color and power Doppler are also helpful in the evaluation of the transplanted kidney and can suggest the presence of transplant rejection. The sonographic color and power Doppler features of disease entities which affect the kidneys are discussed. Knowledge of these sonographic features will enable prompt diagnosis, thereby expediting patient care.

Metastatic lesions of the umbilicus are more common than primary malignancies and are commonly referred to as Sister Mary Joseph nodules. Most arise from the stomach or the female genital tract. We describe an unusual case of renal cell carcinoma with peritoneal implants producing a Sister Mary Joseph nodule diagnosed by CT. To our knowledge, no report of a urinary tract malignancy with umbilical involvement has been described in the radiological literature.