Abstract
Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. This article will highlight key traumatic and non-traumatic causes of acute scrotal pain other than testicular torsion and epididymo-orchitis that may present in the emergency department setting.
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Avery LL, Scheinfeld MH (2013) Imaging of penile and scrotal emergencies. Radiographics 33:721–740
Dogra VS, Gottlieb RH, Oka M, Rubens DJ (2003) Sonography of the scrotum. Radiology 227(1):18–36
Remer EM, Casalino DD, Arellano RS, Bishoff JT, Coursey CA, Dighe M, Fulgham P, Israel GM, Lazarus E, Leyendecker JR, Majd M, Nikolaidis P, Papanicolaou N, Prasad S, Ramchandani P, Sheth S, Vikram R, Karmazyn B (2012) ACR appropriateness criteria acute onset of scrotal pain - without trauma, without antecedent mass. Ultrasound Q 28:47–51
Ragheb D, Higgins JL Jr (2002) Ultrasonography of the scrotum: technique, anatomy, and pathologic entities. J Ultrasound Med 21:171–185
Sung EK, Setty BN, Castro-Aragon I (2012) Sonography of the pediatric scrotum: emphasis on the Ts—torsion, trauma, and tumors. AJR Am J Roentgenol 198(5):996–1003
Dudea SM, Ciurea A, Chiorean A, Botar-Jid C (2010) Doppler applications in testicular and scrotal disease. Med Ultrason 12(1):43–51
Sparano A, Acampora C, Scaglione M, Romano L (2008) Using color power Doppler ultrasound imaging to diagnose the acute scrotum: a pictorial essay. Emerg Radiol 15(5):289–294
Hamper UM, DeJong MR, Caskey CI, Sheth S (1997) Power Doppler imaging: clinical experience and correlation with color Doppler US and other imaging modalities. Radiographics 17(2):499–513
Aso C, Enriquez G, Fite M et al (2005) Gray-scale and color Doppler sonography of scrotal disorder in children: an update. Radiographics 25:1197–1214
Monga M, Scarpero HM, Ortenberg J (1999) Metachronous bilateral torsion of the testicular appendices. Int J Urol 6:589–591
Singh AK, Kao SCS (2010) Torsion of testicular appendage. Pediatr Radiol 40:373
Strauss S, Faingold R, Manor H (1997) Torsion of the testicular appendages: sonographic appearance. J Ultrasound Med 16:189–192
Konicki PJ, Baumgartner J, Kulstad EB (2004) Epididymal abscess. Am J Emerg Med 22(6):505–506
Bhatt D, Dogra VS (2008) Role of US in testicular and scrotal trauma. Radiographics 28(6):1617–1629
Guichard G, El Ammari J, Del Coro C et al (2008) Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology 71(1):52–56
Dogra V, Bhatt S (2004) Acute painful scrotum. Radiol Clin N Am 42:349–363
Deurdulian C, Mittelstadt CA, Chong WK, Fielding JR (2007) US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics 27:357–369
Siegel MJ (1997) The acute scrotum. Radiol Clin N Am 35(4):959–976
Buckley JC, McAninch JW (2006) Diagnosis and management of testicular ruptures. Urol Clin N Am 33(1):111–116
Phonsombat S, Master VA, McAninch JW (2008) Penetrating external genitalia trauma: a 30-year single institution experience. J Urol 180(1):192–196
Cline KJ, Mata JA, Venable DD, Eastham JA (1998) Penetrating trauma to the male external genitalia. J Trauma 44(3):492–494
Mehta AL, Dogra VS (1998) Intratesticular varicocele. J Clin Ultrasound 26:49–51
Das KM, Prasad K, Szmigielski W, Noorani N (1999) Intratesticular varicocele: evaluation using conventional and Doppler sonography. AJR 172:1079–1083
Garriga V, Serran A, Marin A et al (2009) US of the tunica vaginalis testis: anatomic relationship and pathologic conditions. Radiographics 29:2017–2032
Zagoria R, Dyer R, Brady C (2016) Genitourinary imaging: the requisites, 3rd edn. Elsevier, Philadelphia. The Male Genital Tract. p 304–336
Revzin MV, Ersahin D, Israel G et al (2016) US of the inguinal canal: comprehensive review of pathologic processed with CT and MR imaging correlation. Radiographics 36:2028–2048
Joshi S, Mansour AM, Edefrawy A, Soloway MS (2012) Diffuse large B cell lymphoma of the spermatic cord: a case report and review of the literature. Can J Urol 19:6581–6583
Yang DM, Kim HC, Lee HL, Lim JW, Kim GY (2010) Sonographic findings of acute vasitis. J Ultrasound Med 29(12):1711–1715
Chan PT, Schegel PN (2002) Inflammatory conditions of the male excurrent ductal system. J Androl 23(4):453–460
Martin LC, Share JC, Peters C, Atala A (1996) Hydrocele of the spermatic cord: embryology and ultrasonographic appearance. Pediatr Radiol 26:528–530
Sawh SL, O’Leary MP, Ferreira MD et al (2008) Fractured penis: a review. Int J Impot Res 20(4):366–369
Bitsch M, Kromann-Andersen B, Schou J, Sjontoft E (1990) The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. J Urol 143(3):642–645
Hoag NA, Hennessey K, So A (2011) Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review. Can Urol Assoc J 5(2):E23–E26
Levenson RB, Singh AK, Noveline RA (2008) Fournier gangrene: role of imaging. Radiographics 28(2):519–528
Hayeri MR, Ziai P, Shehata ML, Teytelboym OM, Huang BK (2016) Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis. Radiographics 36:1888–1910
Soldatos T, Durand DJ, Subhawong TK, Carrino JA, Chhabra A (2012) Magnetic resonance imaging of musculoskeletal infections: systematic diagnostic assessment and key points. Acad Radiol 19(11):1434–1443
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Author A declares that he has no conflict of interest. This work was performed while a resident at Wake Forest University. The author is currently a fellow at Emory University.
Author B has no conflict of interest. The author is an advisor for Enlitic. (10 Jackson St. San Francisco, CA 94111) and an employee of the Department of Veterans Affairs National Teleradiology Program.
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All images in this manuscript were of studies performed for clinical purposes and incorporated into the manuscript via retrospective review. All patient identification information has been removed. Otherwise, this article does not contain any studies with human participants or animals performed by any of the authors.
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McAdams, C.R., Del Gaizo, A.J. The utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion. Emerg Radiol 25, 341–348 (2018). https://doi.org/10.1007/s10140-018-1606-y
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DOI: https://doi.org/10.1007/s10140-018-1606-y