It probably results from cystic degeneration of the round ligament. Unlike a hydrocele of the cord, a hydrocele of the canal of Nuck is always at least partially within the inguinal canal.The accuracy of the diagnosis must be ascertained. Great care must be taken to differentiate a hydrocele from a scrotal hernia or tumor of the testicle. Ultrasound imaging can be very useful in these cases. A hernia usually can be reduced, transmits a cough impulse, and is not translucent. A hydrocele cannot be reduced into the inguinal canal and gives no impulse on coughing unless a hernia is also present. In young children a hydrocele is often associated with a complete congenital type of hernial sac. Diagnosis
A primary hydrocele is described as having the following characteristics:
Transillumination positive
Fluctuation positive
Impulse on coughing negative (positive in congenital hydrocele)
Reducibility absent
Testis cannot be palpated separately. (exception -  funicular hydrocele, encysted hydrocele)

Treatment
Most hydroceles appearing in the first year of life seldom require treatment as they resolve without treatment. Hydroceles that persist after the first year or occur later in life require treatment only in selected cases, such as patients who are symptomatic with pain or a pressure sensation, or when the scrotal skin integrity is compromised from chronic irritation; the treatment of choice is surgery and the operation is conducted via an open access technique aiming to excise the hydrocele sac. Anesthesia is required for the operation and general anesthesia is of choice in children, while spinal anesthesia is usually sufficient in adults.
Sclerosteosis is an autosomal recessive disorder characterized by bone overgrowth. It was first described in 1958 but given the current name in 1967. Excessive bone formation is most prominent in the skull, mandible and tubular bones. It can cause facial distortion and syndactyly. Increased intracranial pressure can cause sudden death in patients. It is a rare disorder that is most prominent in the Afrikaner population in South Africa (40 patients), but there have also been cases of American and Brazilian families. Cause
Sclerosteosis is caused by mutations in the gene that encode for the sclerostin protein. The sclerostin protein is necessary in inhibiting canonical wnt signalling. Wnt signalling results in increased osteoblast activity and RANKL synthesis, sclerostine therefore increases boneformation by indirectly inhibiting RANKL synthesis and thus osteoclast activitation. References
External links
These Superhumans Are Real and Their DNA Could Be Worth Billions
Sclerostin Inhibition in the Management of Osteoporosis
Effect of bone thickening on the skull area: need of skull removal