Diagnosis

How hernias are diagnosed

Most hernias can be diagnosed on a physical exam. Imaging is used when the diagnosis is uncertain or when planning complex repair.

Medically reviewed byDr. Ariel Ortiz, MD, FACS, FASMBSLast reviewed: December 1, 2026

Physical examination

A focused physical exam by an experienced clinician is the most common and often most accurate way to diagnose a hernia. The exam typically includes inspection and palpation of the area while the patient stands and performs a Valsalva maneuver (coughing or bearing down).

Ultrasound

Ultrasound is a useful first-line imaging test for groin and abdominal wall hernias, particularly when the exam is unclear. It is non-invasive, does not use radiation, and can show the hernia in real time during straining.

CT scan

A CT scan provides high-resolution images of the abdominal wall and is the imaging study of choice for complex ventral and incisional hernias. It allows the surgeon to assess size, contents, loss of domain, and adjacent anatomy.

MRI

MRI is used selectively when soft-tissue characterization is important, such as in suspected sports hernia (athletic pubalgia) or occult groin hernia.

Endoscopy

Upper endoscopy is part of the workup for hiatal hernias, particularly when reflux symptoms are present. It allows visualization of the gastroesophageal junction and the lining of the esophagus and stomach.

Educational disclaimer: This page is for educational purposes only and is not medical advice, diagnosis, or treatment. Individual recommendations require consultation with a qualified healthcare professional.

Sources & references

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