Wk 5, Case 1 - Review

EXAM: US Testicular W/Doppler

INDICATION: 13-year-old male with acute right testicular pain, swelling, and tenderness

TECHNIQUE: Ultrasound imaging of the scrotum and testicles was obtained using two-dimensional grayscale imaging. Color Doppler images were obtained to evaluate vascular flow. Spectral Doppler images were obtained to evaluate quantitative vascular data.

FINDINGS:

The right testicle and right epididymis are enlarged, and the testicle measures 4.2 x 2.4 x 2.9 cm for a total volume of 15 mL. The echogenicity of the right testicular parenchyma is without focal lesion. There is twisting of the spermatic cord in the canal, consistent with a “snail sign.” There is no color Doppler or spectral Doppler flow visualized within the right testicle. A moderate anechoic right hydrocele is present.

The left testicle measures 3.7 x 1.8 x 2.5 cm for a total volume of 9 mL. The testicle is normal in size, contour, and echogenicity. There is no appreciated mass. There is normal symmetric flow to the testicle.

No significant hydrocele or varicocele.

IMPRESSIONS:

1. Right testicular edema and enlargement with twisting of the spermatic cord, compatible with torsion. No Doppler flow. Moderate simple-appearing reactive right hydrocele.
2. Normal left testicle.