The sonographic appearance of testicular microlithiasis detected in a patient presenting with torsion is described. A "speckled" pattern of multiple, tiny bright echoes is produced by calcific concretions in the seminiferous tubules and seems to be characteristic of microlithiasis. Although this condition is not treatable, it should be recognized because it is often associated with extratesticular abnormalities and can obscure superimposed testicular disease.
