Peyronie disease: How can I see the non calcified plaque?

Teaching points 1. To describe the main clinical aspects of Peyronie disease; 2. To point out the main findings in X ray, ultrasound (US), Elastography and MRI; 3. Which complications can occur lately? Content Peyronie´s disease is an uncommon disorder that develops a fibrous plaque in the sheaths covering the penis corpora cavernosa. During the erection the penis usually bend towards the inelastic fibrous plaque. Erectile dysfunction may be related to pain, veno-occlusive dysfunction, or bending of the penis. After a time the plaque can calcifies. Soft tissue radiography of the penis can detect calcified plaques. Penile sonography is the first choice for identification of small lesions, but soft plaques are very difficult to detect. US and MRI detects the number of plaques, their size, and the exact position of the lesions in the penis. Nowadays elastography imaging may be very usefull for detecting those non calcified plaques as the hard plaque can be seen as a hard area in the elastogram. MR imaging of Peyronie disease shows a focal thickening of the tunica albuginea and is best seen on T2-weighted images. An inflammed Peyronie plaque enhances after an intravenous administration of gadolinium and can be detected by Doppler US.