What is the best imaging strategy for diagnosing a painless scrotal mass?

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Ultrasonography is a useful first step in imaging a painless scrotal mass. Ultrasonography is 98% to 100% sensitive for detecting malignant intratesticular lesions requiring surgery, but the specificity is unknown (SOR: C, low-quality observational studies). Magnetic resonance imaging (MRI) is an appropriate second step for identifying malignancy when ultrasonography is equivocal (SOR: C, case series).

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