Table 2.

Sonographic appearance of different testicular lesions included in the differential diagnosis of granulomatous or tuberculous epididymo-orchitis

	Epididymis	Testis	Doppler	Other possible characteristics
Granulomatous or tuberculous epididymo-orchitis	Diffuse enlargement with heterogeneous or rarely homogeneous hypoechoic appearance	Nodular enlargement with heterogeneous hypoechoic appearance or Diffuse testicular enlargement with multiple small hypoechoic nodules	Linear or focal Doppler signal at the periphery of the epididymis	Intra-scrotal extra-testicular calcifications Caseous abscess Sinus tract Skin thickening
Bacterial epididymo-orchitis	Diffuse enlargement with homogeneous hypoechoic appearance	Diffuse enlargement with heterogeneous or homogeneous hypoechoic appearance	Diffuse increased blood flow in the epididymis	Fever Dysuria Scrotal pain Hydrocele Skin thickening
Malignant testicular lesion	Normal unless rare direct extension	Mass of mixed echogenicity	Mixed vascularity in the testis	Calcifications Cysts
Testicular torsion	Normal appearance or Diffuse enlargement with hypoechoic appearance	Normal parenchymal or Diffuse enlargement with hypoechoic (early) or heterogeneous (late) appearance	Reduced or absent blood flow in the testis	Hydrocele Skin thickening Pain