Epididymo-orchitis Presenting as Painful Hemiscrotal SwellingClinical HistoryA 25-year old man presented with symptoms of swelling and pain in the left hemiscrotum. The patient was referred to have an inpatient ultrasound on the same day.Case DescriptionUltrasound revealed a bulky and heterogeneous left epididymis (epididymo-orchitis). The left testis and epididymis both showed evidence of a significantly increased vascularity within them. There was also some reactive hydrocoele in the left hemiscrotum with a heterogeneous collection adjacent to the left epididymis.Diagnosis/ Discussion/ Treatment/ Follow upThe patient’s symptoms resolved after completing antibiotic therapy. A subsequent ultrasound post-treatment confirmed the resolution of symptoms.SonogramsA panoramic image of the left hemiscrotum, in B-mode, showing an inflamed left epididymisB-mode image of the inflamed left testis and left epididymisHeterogeneous (complex) fluid collection in the left hemiscrotum adjacent to the left epididymis. No internal vascularity seen in the collection, as it is not a lesionB-mode left hemiscrotum showing the bulky and inflamed left epididymisColour Doppler imaging showing hypervascularity of the left testis and epididymis in a ‘christmas tree’ fashionPublished on: September 25, 2024
