Genitourinary Radiology > Male Pelvis > Testis > Epididymitis


Epididymitis is the most common acute scrotal process in postpubertal age group, nine times more common than the main differential consideration, testicular torsion. It is thought to be caused by retrograde spread of infection from the urethra or prostate. 90% present with pyuria. Ultrasonography demonstrates enlarged and hypoechoic epididymis, hydrocele or pyocele, scrotal skin thickening, increased color flow surrounding symptomatic epididymis. Associated orchitis may or may not be seen.

1. Asymptomatic and 2. symptomatic color Doppler images of this patient's epididmis shows an enlarged epididymis (compared with asymptomatic side). In addition, the symptomatic epididymis was hyperemic (demonstrated increased color flow compared with the contralateral epididymis) consistent with epididymitis.

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