Changes

In Swedish practice, an inguinal bulge is evaluated within 2 months unless there's significant pain.<ref group=notes>{{NU Hospital GroupInguinal hernia - indication and choice of modality}}</ref>

===How soon===In strong '''[[abdominal pain]]'''Swedish practice, a suspected strangulated hernia indicates surgery without previous ultrasound, whereas ultrasonography of an unclear diagnosis indicates '''[[abdominal CT]]'''inguinal bulge is performed within 2 months unless there is significant pain.<ref group=notes>{{NU Hospital Group}}</ref>

Without and with Valsalva maneuver.<ref name="JamadarJacobson2006">{{cite journal|last1=Jamadar|first1=David A.|last2=Jacobson|first2=Jon A.|last3=Morag|first3=Yoav|last4=Girish|first4=Gandikota|last5=Ebrahim|first5=Farhad|last6=Gest|first6=Thomas|last7=Franz|first7=Michael|title=Sonography of Inguinal Region Hernias|journal=American Journal of Roentgenology|volume=187|issue=1|year=2006|pages=185–190|issn=0361-803X|doi=10.2214/AJR.05.1813}}</ref> Preferably also in standing.<ref name="JamadarJacobson2006"/> Look primarily for an increased diameter of the inguinal canal, which is normally 2 cm (±1 cm in standard deviation) at the deep inguinal ring.<ref group="notes">±2.2cm ±1.08cm in Africans, and 2.1 cm 0.41 ±0.58cm in Europeans.</ref><ref name="MituraKozieł2018">{{cite journal|last1=Mitura|first1=Kryspin|last2=Kozieł|first2=Sławomir|last3=Pasierbek|first3=Michał|title=Ethnicity-related differences in inguinal canal dimensions between African and Caucasian populations and their potential impact on the mesh size for open and laparoscopic groin hernia repair in low-resource countries in Africa|journal=Videosurgery and Other Miniinvasive Techniques|volume=13|issue=1|year=2018|pages=74–81|issn=1895-4588|doi=10.5114/wiitm.2018.72579}}</ref>

===Further workup if not NOT detected===If the pain location may suggest it, also consider performing an '''[[Ultrasonography of femoral hernia]]''' and/or '''[[Ultrasonography of hydronephrosis]]'''in the same session.