Frauscher et al identified persistent lesions seen within the scrotum of extreme mountain bikers during ultrasonography. The prevalence of scrotal lesions is significantly higher in mountain bikers compared to nonbikers. The authors are from University Hospital Innsbruck in Austria.


Patient selection: > 5,000 km per year off-road biking (>= 2 hours per day for >= 6 days per week)


Types of lesions in extreme mountain bikers:

(1) lesions associated with acute trauma (hematoma, etc)

(2) persistent lesions


One or more persistent lesions were identified during ultrasonography in 94% of mountain bikers.


About half of the riders had intermittent scrotal tenderness or discomfort; all of these had scrotal findings. Most riders who were asymptomatic had one or more scrotal findings.


Lesions seen in most mountain bikers (> 80%):

(1) scrotal calculi


Lesions seen in many mountain bikers (25 - 50%):

(1) epididymal cyst

(2) epididymal calcifications

(3) testicular calcifications

(4) hydroceles


Lesions seen in a few mountain bikers (1-11%):

(1) varicocele

(2) testicular microlithiasis


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