Epididymoorchitis mimicking testicular torsion in Henoch-Schonlein purpura

Henoch-Schonlein purpura, although being a systemic vasculitis, mostly invo lves skin, gastrointestinal system, joints, and kidneys. Testicular involve ment is a rare occurrence. A 7-year-old boy with Henoch-Schonlein purpura d eveloped acute scrotum and was referred to rule out testicular torsion. On gray-scale ultrasonography, the testes and epididymis were slightly enlarge d, and had heterogeneous and hypoechoic echotexture. The scrotal wall was t hickened as well. Color and power Doppler ultrasonography revealed increase d vascularity in scrotal contents. Testicular torsion was excluded and the diagnosis of testicular involvement of Henoch-Schonlein purpura was establi shed. Color Doppler US, together with gray-scale findings, can be useful in the evaluation of Henoch-Schonlein purpura with acute scrotum, excluding t esticular torsion and preventing unnecessary surgery.