Acute scrotal pain can be due to different causes. Torsion of the spermatic cord must be identified in emergency, as delay in intervention may cause irreversible testicular damage. The commonest cause for acute scrotal pain in adults is bacterial epididymitis, normally managed successfully with antibiotics. Complications arising from severe inflammatory changes such as abscess formation and parenchymal ischemia may be seen. The main role of US in appendiceal torsion is to rule out testicular torsion or epididymo-orchitis. Other causes of acute scrotal pain are segmental testicular infarction and vasculitides. Conditions that arise outside the scrotum, such as renal colic, can present clinically with acute scrotal pain. Grayscale US and conventional Doppler modes are the methods of choice for patients with the clinical presentation of acute scrotal pain. CEUS and elastographic modes can have a role in selected cases.
KeywordsTestis Ultrasound Acute scrotal pain Imaging Acute scrotum Causes
Renal colic in a patient presenting with right acute scrotal pain. Coronal unenhanced CT views showing a stone in the lombar tract of the right ureter. (AVI 12549 kb)
Renal colic in a patient presenting with right acute scrotal pain. Axial unenhanced CT views showing a stone in the lombar tract of the right ureter(AVI 20486 kb)
- 14.Tsili AC, Bertolotto M, Turgut AT, Dogra V, Freeman S, Rocher L, Belfield J, Studniarek M, Ntorkou A, Derchi LE, Oyen R, Ramchandani P, Secil M, Richenberg J. MRI of the scrotum: recommendations of the ESUR scrotal and penile imaging working group. Eur Radiol. 2018;28(1):31–43. https://doi.org/10.1007/s00330-017-4944-3.PubMedGoogle Scholar