Testicular Ultrasound

  • Angela Bray CredittEmail author
  • Jordan Tozer


There are many conditions that can affect the testes and scrotum, some of which are more concerning than others. The most severe, testicular torsion occurs when blood supply to one testicle is blocked resulting in death of the testicle if not diagnosed in a timely manner. For other disorders, such as malignancy, hydrocele, epididymitis, and orchitis, while not imminently threatening, it is important that these be diagnosed and treated to prevent sequelae of disease. Ultrasound has proven to be an important imaging modality to evaluate for and diagnose these conditions as it is quick and easy to perform. This chapter will review indications of performing a testicular ultrasound, basic testicular and scrotal anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.


Hydrocele Varicocele Testicular torsion Epididymitis Orchitis Fournier’s gangrene 

Supplementary material

Video 13.1

Normal testicle. Longitudinal view of normal testicle using linear probe showing homogenous testicular architecture (MP4 2227 kb)

Video 13.2

Color Doppler. Longitudinal view of normal testicle showing normal blood flow with color Doppler (MP4 272 kb)

Video 13.3

Normal epididymis. Along the posterior aspect of each testicle is the epididymis, which has a head, body, and tail. The head, as seen here, is typically positioned posterolateral to the upper pole of the testicle (MP4 2021 kb)

Video 13.4

Hydrocele. Moderate-sized hydrocele seen adjacent to a normal testicle (MP4 475 kb)

Video 13.5

Varicocele. Varicoceles appear as a cluster of enlarged or engorged vascular structures in the pampiniform plexus adjacent to the testicle (MP4 2269 kb)

Video 13.6

Varicocele with color. Varicocele shown in this case with pronounced color flow. This can be augmented with by having the patient perform the Valsalva maneuver (MP4 609 kb)

Video 13.7

Testicular torsion. The affected testicle will appear enlarged with loss of the typical homogenous architecture (MP4 2238 kb)

Video 13.8

Color Doppler testicular torsion. Note the loss of normal testicular architecture and almost no flow using color Doppler in this patient with testicular torsion (MP4 424 kb)

Video 13.9

Power Doppler of a normal testicle. Single testicle in longitudinal view showing normal flow by power Doppler (MP4 2011 kb)

Video 13.10

Power Doppler in testicular torsion. Right testicle with the absence of flow using color Doppler indicating testicular torsion (MP4 1701 kb)

Video 13.11

Epididymitis color Doppler. Color Doppler will demonstrate increased vascularity and blood flow to the infected epididymis (MP4 696 kb)

Video 13.12

Testicular mass. Large testicular mass with various echogenicity distorting normal testicular architecture (MP4 2208 kb)


  1. 1.
    Adhikari S. Chapter 13: Testicular. In: Ma OJ, Mateer JR, Reardon RF, Joing SA, editors. Emergency ultrasound. 3rd ed. New York: McGraw-Hill Education; 2014. p. 353–80.Google Scholar
  2. 2.
    Goldenberg E, Gilbert BR. Chapter 4: Scrotal ultrasound. In: Gilbert BR, editor. Ultrasound of the male genitalia. New York: Springer; 2015. p. 75–124.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Emergency MedicineVirginia Commonwealth University Medical CenterRichmondUSA

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