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Sonographic features of focal orchitis
J F Lentini1, C B Benson, J P Richie
1Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Summary
High-resolution ultrasound can identify testicular infections, differentiating them from tumors. Specific sonographic signs of focal orchitis can prevent unnecessary surgeries.
Area of Science:
- Radiology
- Urology
- Pathology
Background:
- High-resolution sonography is crucial for detecting intratesticular pathology.
- Distinguishing intratesticular lesions (often malignant) from extratesticular ones (usually benign) is accurate.
- Reliable sonographic criteria to differentiate testicular neoplasms from focal benign lesions like infection are lacking.
Observation:
- Three cases of focal orchitis presented with specific sonographic features.
- A focal peripheral hypoechoic intratesticular abnormality was observed.
- This abnormality was poorly defined or crescent-shaped, adjacent to an enlarged epididymis.
Findings:
- The described sonographic features allowed for a confident diagnosis of intratesticular infection (focal orchitis).
- These findings suggest that specific imaging patterns can indicate infection rather than neoplasm.
- Rapid sonographic improvement within 2-4 weeks and follow-up to resolution are key.
Implications:
- Sonographic diagnosis of focal orchitis can prevent unnecessary orchiectomy.
- Early and accurate diagnosis through specific ultrasound findings improves patient outcomes.
- This study highlights the potential of high-resolution sonography in guiding clinical management of testicular conditions.