← All patient updates Groin hernia · Reviewed November 2026

Groin hernia: do you need an ultrasound first?

What's new

Choosing Wisely Canada, together with the Canadian Association of General Surgeons, recommends not routinely using ultrasound to check a groin hernia that can already be seen or felt. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) makes the same recommendation in its Choosing Wisely list. Most groin hernias are diagnosed by a doctor examining you, and an ultrasound rarely changes what happens next.

What this means for you

If your doctor can see or feel a bulge in your groin, you usually do not need an ultrasound before being referred to a surgeon.
Waiting for an ultrasound can delay your surgical consultation without changing your treatment plan.
An ultrasound can sometimes miss a hernia, or show a small one that isn't the cause of your symptoms, which can add confusion.
Imaging is still useful when the diagnosis is unclear, for example groin pain without a bulge, or when another cause is suspected. If it is needed, your surgeon can arrange it.
At your consultation, your surgeon will examine you standing and lying down, which is the most reliable way to find a groin hernia.

Go to the Emergency Department right away if your hernia becomes hard, very painful, red or discoloured, will not go back in, or you have vomiting or cannot pass gas or stool.

For referring physicians

We accept referrals for clinically evident groin hernias without imaging. Please include a brief description of your examination findings and symptoms. See our Referrals page for how to refer directly or through FAST.

Sources (for clinicians)

Choosing Wisely Canada / Canadian Association of General Surgeons. General Surgery, Recommendation 1: Don't use ultrasound routinely to evaluate clinically evident inguinal hernias (updated May 2026).

Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Choosing Wisely: Avoid the routine use of ultrasound in evaluating clinically apparent inguinal hernia.

HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1–165.

Konkin DE. Avoid the routine use of ultrasound in evaluating clinically apparent inguinal and umbilical hernias. BCMJ. 2019;61(7):276.

Reviewed by the surgeons of Summit Surgical, November 2026. General information only — your surgeon will advise on your own situation.