Imaging of the Epididymis

Abstract

Ultrasonography performed with a high-frequency transducer is the modality of choice for evaluating acute and nonacute scrotal disease. Acute epididymitis and epididymo-orchitis are the most common conditions that present with acute scrotal pain. Differentiation of these from testicular torsion is important for determining the appropriate management. High-transducer sonography allows the visualization of the epididymis and its detailed anatomy. We present important sonographic features of epididymitis and epididymo-orchitis caused by infectious and noninfectious etiologies. Features of benign and malignant epididymal lesions, including epididymal cysts, spermatoceles and tubular ectasia, sperm granulomas, adenomatoid tumors, leiomyomas, papillary cyst adenomas, lymphoma, and metastases are also presented. In addition, epididymal trauma and torsion are discussed. The goal of the review is to provide the radiologist with a better understanding of the numerous pathological conditions that occur in the epididymis.

Crimean-Congo haemorrhagic fever presenting as epididymo-orchitis

“…4,5 The epididymis is a vascularly rich organ. 6 Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. In acute epididymitis, symptoms are characterized by pain and swelling.…”

“…Doppler USG is an especially valuable technique in diagnosis. 6,7 We report a case of CCHF, admitted to our clinic in summer, presenting with acute epididymo-orchitis. This is the first reported case of CCHF with epididymo-orchitis.…”

Epididymal Cysts in Childhood - Conservative or Surgical Approach?

“…on the contrary to adolescent cysts most of these cysts detected in adults are spermatocele (5). ECs are less common than spermatoceles and are indistinguishable from the latter both at palpation and at US (6,7). ECs contain clear serous fluid and may arise throughout the epididymis while spermatoceles are filled with sperm and almost always arise in the epididymal head.…”

“…ECs while examine clinically present as extratesticular, fluctuant, firm swellings which usually can be easily palpable separate from the testicle. Scrotal ultrasound is recommended to confirm or help diagnosis in unclear cases (6,7,8). ECc and spermatoceles are differentiated from acute or chronic epididymitis, hydroceles, varicoceles, extratesticular scrotal masses (lipomas, lymphangiomas), epididymal tumours (adenomatoid tumour), testicular tumours (9,10).…”

The Infertile Male-3: Endocrinological Evaluation

“…In addition, small calcifications can be observed in Klinefelter syndrome (Aizenstein et al 1997). Epididymis inhomogeneity, hypo-or hyper-echogenicity, and coarse epididymal calcifications, especially of the tail, suggest the presence of chronic inflammations (Isidori and Lenzi 2008;Woodward et al 2003;Lee et al 2008). Epididymal subobstruction can be found at ultrasonography evaluation (Woodward et al 2003).…”