Multimodality imaging features of Canal-of-Nuck hydrocele in adults


      • Canal of Nuck abnormalities are rare in adult females. The most common pathology is a hydrocele of the canal of Nuck.
      • On Ultrasound, typically they are simple cysts shows fluid attenuation, thin walled, hypoenhancing solitary focus.
      • MRI shows T2 hyperintense and T1 hypointense, non-enhancing focus with facilitation diffusion. On PET/CT there is no uptake of F-18 FDG leading to photopenia.


      Canal of Nuck abnormalities are common in pediatric population but may rarely present in adults. Hydrocele of the Canal of Nuck is the most common presentation in adult population. These may be symptomatic or found incidentally on imaging. We review the embryology and present imaging features of Canal of Nuck hydroceles in this case-based review article, and highlight the features on various imaging modalities, such as ultrasound, CT (Computed Tomography), MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography). Radiologists should be aware of these findings in their practice and be able to recognize these congenital abnormalities.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Nasser H.
        • King M.
        • Rosenberg H.K.
        • Rosen A.
        • Wilck E.
        • Simpson W.L.
        Anatomy and pathology of the canal of Nuck.
        Clin Imaging. 2018; 51 (published Online First: 20180207): 83-92
        • Kim K.S.
        • Choi J.H.
        • Kim H.M.
        • et al.
        Hydrocele of the canal of nuck in a female adult.
        Arch Plast Surg. 2016; 43 (published Online First: 20160921): 476-478
        • Pandey A.
        • Jain S.
        • Verma A.
        • Jain M.
        • Srivastava A.
        • Shukla R.C.
        Hydrocele of the canal of nuck - rare differential for vulval swelling.
        Indian J Radiol Imaging. 2014; 24: 175-177
        • Thomas A.K.
        • Thomas R.L.
        • Thomas B.
        Canal of nuck abnormalities.
        J Ultrasound Med. 2020; 39 (published Online First: 20190804): 385-395
        • Counseller V.S.
        • Black B.M.
        Hydrocele of the canal of nuck: report of seventeen cases.
        Ann Surg. 1941; 113: 625-630
        • Tubbs R.S.
        • Loukas M.
        • Shoja M.M.
        • Salter E.G.
        • Oakes W.J.
        Indirect inguinal hernia of the urinary bladder through a persistent canal of nuck: case report.
        Hernia. 2007; 11 (published Online First: 20070206): 287-288
        • Choi K.H.
        • Baek H.J.
        Incarcerated ovarian herniation of the canal of nuck in a female infant: ultrasonographic findings and review of literature.
        Ann Med Surg (Lond). 2016; 9 (published Online First: 20160618): 38-40
        • Choi Y.M.
        • Lee G.M.
        • Yi J.B.
        • et al.
        Two cases of female hydrocele of the canal of nuck.
        Korean J Pediatr. 2012; 55 (published Online First: 20120430): 143-146
        • Jagdale R.
        • Agrawal S.
        • Chhabra S.
        • Jewan S.Y.
        Hydrocele of the canal of nuck: value of radiological diagnosis.
        J Radiol Case Rep. 2012; 6 (published Online First: 20120601): 18-22
        • Rees M.A.
        • Squires J.E.
        • Tadros S.
        • Squires J.H.
        Canal of nuck hernia: a multimodality imaging review.
        Pediatr Radiol. 2017; 47 (published Online First: 20170425): 893-898
        • Rajput A.
        • Gauderer M.W.
        • Hack M.
        Inguinal hernias in very low birth weight infants: incidence and timing of repair.
        J Pediatr Surg. 1992; 27: 1322-1324
        • Kono R.
        • Terasaki H.
        • Murakami N.
        • Tanaka M.
        • Takeda J.
        • Abe T.
        Hydrocele of the canal of nuck: a case report with magnetic resonance hydrography findings.
        Surg Case Rep. 2015; 1 (published Online First: 20150922): 86
        • Shadbolt C.L.
        • Heinze S.B.
        • Dietrich R.B.
        Imaging of groin masses: inguinal anatomy and pathologic conditions revisited.
        Radiographics. 2001; (21 Spec No:S261-71)
        • De Meulder F.
        • Wojciechowski M.
        • Hubens G.
        • Ramet J.
        Female hydrocele of the canal of nuck: a case report.
        Eur J Pediatr. 2006; 165 (published Online First: 20060117): 193-194
        • Topal U.
        • Saritas A.G.
        • Ulku A.
        • Akcam A.T.
        • Doran F.
        Cyst of the canal of nuck mimicking inguinal hernia.
        Int J Surg Case Rep. 2018; 52 (published Online First: 20181010): 117-119
        • Huang C.S.
        • Luo C.C.
        • Chao H.C.
        • Chu S.M.
        • Yu Y.J.
        • Yen J.B.
        The presentation of asymptomatic palpable movable mass in female inguinal hernia.
        Eur J Pediatr. 2003; 162 (published Online First: 20030426): 493-495
        • Oh T.H.
        • Lee Y.H.
        • Seo I.Y.
        Diagnostic efficacy of contrast-enhanced ultrasound for small renal masses.
        Korean J Urol. 2014; 55 (published Online First: 20140905): 587-592
        • Sarkar S.
        • Panja S.
        • Kumar S.
        Hydrocele of the canal of nuck (Female Hydrocele): a rare differential for inguino-labial swelling.
        J Clin Diagn Res. 2016; 10(2):PD21-2 ([published Online First: 20160201])
        • Bronsther B.
        • Abrams M.W.
        • Elboim C.
        Inguinal hernias in children--a study of 1,000 cases and a review of the literature.
        J Am Med Womens Assoc. 1972; 27 (1972) (passim): 522-525