Fig. 8.

Epididymitis and testicular appendage torsion. a Transverse color Doppler US image of both testes in a 9-year-old boy with left-side pain shows hyperemia in the left testis and thickened epididymis (E) with surrounding hydrocele and left scrotal wall edema, all favoring left epididymo-orchitis. b Longitudinal color Doppler US image of the left scrotum in a 10-year-old boy with acute pain shows a globular, enlarged, echogenic and avascular nodular structure (arrows) at the superior pole of the testis, compatible with torsion of the testicular appendage. Not infrequently, reactive inflammatory change involves the ipsilateral testis and epididymis