DIAGNOSTIC-IMAGING OF PATIENTS WITH ACUTE SCROTAL PAIN

Common causes of acute scrotal pain include testicular torsion, epidid ymo-orchitis and trauma. Epididymitis in adult men is typically associ ated with a history of urinary tract infection or prostatitis. Testicu lar torsion typically presents in young adults with a sudden onset of severe scrotal pain and, frequently, a history of recurrent episodes t hat have spontaneously resolved. With scrotal trauma, ultrasound may d emonstrate testicular fracture, hematoceles and areas of hemorrhage or testicular infarction. Since both epididymitis and testicular torsion present with scrotal pain and swelling, and may be accompanied by fev er and pyuria, Doppler ultrasound or radionuclide imaging may be neces sary to make the diagnosis. In acute testicular torsion, color Doppler ultrasound shows absent flow to the epididymis and testis, while nucl ear imaging shows central photon-deficient areas in the ischemic hemis crotum. In epididymo-orchitis, color Doppler ultrasound shows increase d flow to the epididymis and testis, while nuclear imaging shows incre ased perfusion of the affected testis and hemiscrotum.