Sonography of large scrotal infections

We have described 14 cases of large scrotal infections with diffuse involvement of testis and epididymis, thick septations within the cavity, and associated thickening of the scrotal wall and tunica albuginea. The combination of these findings should help distinguish this process from a diffuse neoplastic involvement of the testis where the scrotal wall is almost always of normal thickness. The presence of patchy inhomogenous testicular echo pattern should alert the sonologist to the presence of diffuse suppurative epididymo-orchitis, which may result in necrosis with subsequent orchiectomy in such patients.