201- What is the role of ultrasonography in the evaluation of precocious puberty in boys?
Ultrasonography of the testes is useful for determination of exact size of testes,
particularly at Tanner stage 2 (testicular volume 3–4 ml or testicular length
>25 mm). An ultrasonography testis is also useful in evaluation of disorders
associated with asymmetrical testicular growth including Leydig cell tumor,
MAS, and CAH with testicular adrenal rest tumor (TART). Leydig cell tumors
are usually very small (2–3 mm) and can be missed on routine palpation of tes-
tes. Further, gynecomastia versus lipomastia can also be differentiated by ultra-
sonography of the breast.- Is neuroimaging indicated in all children with GDPP?
Contrast-enhanced MRI brain is indicated in all children with GDPP. The prob-
ability of having an intracranial pathology is higher in boys than in girls. IndFig. 6.14 (continued)
6 Precocious Puberty