Color flow and spectral Doppler ultrasound are the backbone of scrotal imaging when evaluating acute scrotal pain. Testicular Torsion is one of the most common causes of acute scrotal pain but can be a challenging diagnosis both clinically and sonographically. This article will review the pertinent Doppler ultrasound findings that can help make the diagnosis of both complete and partial torsion. A review of other causes of testicular ischemia will also be included as these pathologies can mimic Testicular Torsion.

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Intratesticular masses are common and widely presumed to be malignant until proven otherwise. The most common testicular tumors include germ cell and non-germ cell tumors, typically presenting as solitary, unilateral lesions. Some testicular tumors present with bilateral involvement, the most common of which is Leydig cell hyperplasia, with case reports of other synchronous and metachronous bilateral testicular tumors in the literature. Testicular plasmacytomas in the setting of multiple myeloma have been reported as well but are uncommon. Bilateral testicular plasmacytomas are extremely rare. We present sonographic features, with histopathologic correlation in a 71-year-old man who presented with scrotal pain and was found to have bilateral testicular hypoechoic masses confirmed to be plasmacytomas.

Purpose: The Fluency s Plus Endovascular Stent Graft for Instent Restenosis (RESCUE) study is a multicenter, randomized, concurrently controlled study, comparing the safety and effectiveness of the stent graft to balloon angioplasty (PTA) for treatment of in-stent restenotic lesions in the venous outflow of the arteriovenous (AV) access circuit of hemodialysis patients with AV grafts or AV fistulae. Materials and Methods: 265 patients from 23 U.S. sites were randomized to PTA versus PTA plus placement of the stent graft. The primary study endpoints were access circuit primary patency (ACPP) through 6 months and safety through 30 days. The secondary endpoint of post-intervention lesion patency (PLP) (re-intervention at the original treatment site or abandonment for permanent access), was also hypothesis tested. A 90-day follow-up angiogram assessment of binary restenosis was completed by an independent Core Lab. Results: The intention-to-treat (ITT) population included 265 randomized patients, of whom 244 were evaluated for 30-day safety, and 220 for 6-month effectiveness (111 PTA alone and 109 stent graft). The overall ACPP rate at 6 months was significantly higher in the stent graft group (16.7%) than in the PTA group (3.0%; po0.001). PLP at 6 months was 65.2% in the stent graft group and 10.4% in the PTA group (po0.001). The stent graft group also demonstrated a significantly higher PLP rate in the two strata (AVG and AVF). In the AVG subgroup, the PLP rate was 57.7% vs. 5.2% (stent graft vs. PTA; po0.001). In the AVF subgroup, the PLP rate was 72% vs. 14.7% (stent graft vs. PTA; po0.001). In subjects with central vein lesions, the PLP at 6 months was 67% vs. 0% (stent graft vs. PTA; po0.001). The 90-day freedom from binary restenosis rate was 81% in the stent graft group vs. 25% with PTA alone. Freedom from safety events through 30 days was comparable between groups (96.8% PTA; 96.6% stent graft; p ¼ 0.007). Conclusion: The Fluency s Plus Endovascular Stent Graft is superior to PTA alone for both ACPP and PLP rates through 6 months in the treatment of in-stent restenosis in the access circuit of patients dialyzing with AV grafts and AV fistulae.

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