Editing Peyronie's disease (section)

==Diagnosis==
[[File:Peyronie's Disease Ultrasound.jpg|thumb|This ultrasound depicts cross sections of the penis at different locations in a patient with Peyronie's disease.  The top image shows normal anatomy whereas the bottom image shows scar tissue on the [[tunica albuginea (penis)]]. The scar tissue is localized and responsible for the hallmark deformities of Peyronie's disease (curvature and narrowing).]]
Peyronie's disease [[diagnosis]] is mostly [[Clinical diagnosis|clinical]]. [[Medical history|Patient history]] and [[physical examination]] are crucial. The most prominent features are acquired penile curvature, palpable plaques, erectile dysfunction, and pain during erections. [[Penile ultrasonography]] is the imaging method of choice for plaque location, measurement, and confirmation of [[calcification]]. [[Doppler ultrasonography|Doppler ultrasound]] can be utilized to assess [[Vascular function curve|vascular function]], which is useful in the evaluation of associated [[erectile dysfunction]]. Imaging also helps to differentiate PD from congenital penile curvature, [[penile fracture]], or [[neoplastic disease]]. [[Magnetic resonance imaging|MRI]] can be employed in severe ones, although it is generally not required.<ref>{{cite journal |vauthors=Amin Z, Patel U, Friedman EP, Vale JA, Kirby R, Lees WR |title=Colour Doppler and duplex ultrasound assessment of Peyronie's disease in impotent men |journal=The British Journal of Radiology |volume=66 |issue=785 |pages=398–402 |date=May 1993  |pmid=8319059 |doi=10.1259/0007-1285-66-785-398}}</ref>
[[File:Bent penis erected.jpg|thumb|Bent penis due Peyronie's disease]]

===Ultrasonography===
On [[penile ultrasonography]], the typical appearance is [[hyperechoic]] focal thickening of the tunica albuginea. Due to associated calcifications, the imaging of patients with Peyronie's disease shows acoustic shadowing, as illustrated in figures below. Less common findings, attributed to earlier stages of the disease (still mild fibrosis), are hypoechoic lesions with focal thickening of the paracavernous tissues, echoic focal thickening of the tunica without posterior acoustic shadowing, retractile [[Isochoic wave|isoechoic]] lesions with posterior attenuation of the beam, and focal loss of the continuity of the tunica albuginea.

In the Doppler study, increased flow around the plaques can suggest inflammatory activity and the absence of flow can suggest disease stability. Ultrasound is useful for the identification of lesions and to determine their relationship with the neurovascular bundle. Individuals with Peyronie's disease can present with erectile dysfunction, often related to venous leakage, due to insufficient drainage at the site of the plaque. Although plaques are more common on the dorsum of the penis, they can also be seen on the ventral face, lateral face, or septum.<ref name="FernandesSouza2018">Originally copied from:<br />{{cite journal|last1=Fernandes|first1=Maitê Aline Vieira|last2=Souza|first2=Luis Ronan Marquez Ferreira de|last3=Cartafina|first3=Luciano Pousa|title=Ultrasound evaluation of the penis|journal=Radiologia Brasileira|volume=51|issue=4|year=2018|pages=257–261|issn=1678-7099|doi=10.1590/0100-3984.2016.0152|pmid=30202130|pmc=6124582}}<br />[[Creative Commons|CC-BY]] license</ref>

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File:Ultrasonography of orpus cavernosum calcification.jpg|Transverse ultrasound of the penis, in a ventral view, in the middle portion of the penis. Note the echoic image with posterior acoustic shadowing, corresponding to calcification (arrow), in the left corpus cavernosum.<ref name="FernandesSouza2018"/> 
[[File:X-ray of corpus spongiosum calcifications.jpg|[[Projectional radiography]] ("X-ray"), penetrating the soft parts of the penis, showing radiopaque images that correspond to calcifications in the corpora cavernosa (arrows).]]
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