Testicular microlithiasis is condition seen bilaterally with tiny specks of calcification typically not showing posterior acoustic shadowing. "Starry sky" appearance best describes the condition.

Its association with germ cell tumors is contentious but it is also associated with infertility.

One grading system used on ultrasound is:

• grade I: less than 10 microcalcifications
• grade II: 10 to 20 microcalcifications
• grade III: more than 20 microcalcifications