Role of US in acute scrotal pain

Liguori, Giovanni; Bucci, Stefano; Zordani, Alessio; Benvenuto, Sara; Ollandini, Giangiacomo; Mazzon, Giorgio; Bertolotto, Michele; Cacciato, Francesca; Siracusano, Salvatore; Trombetta, Carlo

doi:10.1007/s00345-011-0698-8

Cited by 24 publications

(17 citation statements)

References 18 publications

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“…Testicular US is extensively used to detect all the conditions causing vascular hypoperfusion (spermatic cord torsion, missed torsion, abscess formation and parenchymal fracture), Doppler ultrasonography for diagnosis of testicular torsion had 94% sensitivity, 96% specificity, 95.5% accuracy and 89.4% positive predictive value (PPV) and a 98% negative predictive value (NPV) 10 11. Despite this data it is well known that colour Doppler is not sensitive enough to make any diagnosis of testicular flow in children.…”

Section: Discussionmentioning

confidence: 99%

Segmental haemorrhagic infarction of the testis in a paediatric patient: a rare aftermath of epididymitis

et al. 2013

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Testicular infarction is an uncommon finding in paediatric age and is usually due to testicular torsion or trauma causing venous rupture with thrombosis and/or arteriolar obstruction. Other causes of segmental infarction of the testes are represented by polyarteritis nodosa, thromboangioiitis obliterans and hypersensitivity angiitis. A few cases of testicular infarction due to epididymitis have been described in the literature related mainly to adult patients. Epididymitis is usually treated in the outpatient setting with close follow-up, but according to our present experience, and reviewing the literature, there may be some cases in which, surgical exploration is mandatory in order to avoid testicular damage.

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Section: Discussionmentioning

confidence: 99%

Segmental haemorrhagic infarction of the testis in a paediatric patient: a rare aftermath of epididymitis

et al. 2013

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“…This finding, in fact, is related to the dilatation of superficial vessels in an attempt to open collaterals to the testis and it takes time, usually a few hours, to become visible. [1][2][3] The degree of torsion is the other important factor that affects imaging findings.…”

Section: Testicular Torsionmentioning

confidence: 99%

“…On CEUS these lesions do not enhance, but the surrounding parenchyma may show avid enhancement. 3,12,15,24…”

Section: Focal Testicular Lesions In Patients With Trauma or Infectionmentioning

confidence: 99%

Pitfalls in Imaging for Acute Scrotal Pathology

Bertolotto

Cantisani

Valentino

et al. 2016

Seminars in Roentgenology

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Differentiation among the many clinical situations that can present with acute scrotal pain is a significant diagnostic problem in clinical practice. A firm diagnosis is often difficult based on clinical history and physical examinations alone, and imaging is usually requested for this purpose. However, imaging findings alone may not clarify the diagnosis as imaging studies have to be interpreted in close correlation with clinical information and with knowledge of the possible pathologic situations underlying the clinical presentation of the specific patient.\ud \ud In this article we describe and discuss the most common problems encountered when performing diagnostic studies for acute scrotal symptoms and the solutions for, possibly, avoiding them

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“…Although pain rarely results in death, the underlying cause can lead to testicular atrophy, necrosis, sterility, and other associated morbidities. 2 In less urgent cases, pain is frequently associated with torsion of the spermatic cord, which, if left untreated, can lead to more severe outcomes, such as necrosis. 3 Other causes of testicular and pelvic discomfort in males include palpable masses presenting as a hydrocele, spermatocele, or varicocele.…”

mentioning

confidence: 99%

“…3 Other causes of testicular and pelvic discomfort in males include palpable masses presenting as a hydrocele, spermatocele, or varicocele. 2 These conditions are less acute as compared with immediate pain and dysfunction, but patients must be referred for imaging to rule out neoplasms. 4 An estimated 7% to 24% of the general population will develop chronic pelvic pain syndrome.…”

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confidence: 99%

Nontraumatic Testicular Pain due to Sacroiliac-Joint Dysfunction: A Case Report

Leone

Middleton

2016

Journal of Athletic Training

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Objective: To discuss the case of a 49-year-old man who presented to the sports medicine staff with pelvic pain of 10 years' duration consistent with pudendal neuralgia.Background: Testicular pain in men is often provoked by direct trauma or may indicate an oncologic process.Differential Diagnosis: Epididymitis, athletic pubalgia, testicular tumor, sacroiliac joint dysfunction, lumbar radiculopathy.Treatment: The patient responded positively to treatment and rehabilitation to restore normal mechanics to the lumbopelvic-hip complex. Several flare-ups since the initial treatment have been of short duration (,2 days) and less intense.Uniqueness: Pudendal neuralgia tends to affect females more than males due to changes in the alignment and stability of the pelvis from a combination of a shorter, wider pelvis and muscle imbalances associated with childbirth. Typically, males with testicular pain suffer from epididymitis or some type of testicular torsion, which was not the situation in this case. Compression is also a common cause of pudendal neuralgia, although it was not responsible for this patient's pain, making diagnosis and treatment complex.Conclusions: Many pain syndromes can be treated with removal of the original stimulus. However, recognizing the factors contributing to pelvic pain and dysfunction in males can be a challenge for the sports medicine professional. A vigilant and unassuming approach to male pelvic pain is warranted, particularly by health care providers in diverse practice settings.

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Role of US in acute scrotal pain

Abstract: In conclusion, we are firmly convinced that a scrotal ultrasound should always be performed in the presence of acute scrotal pain. Moreover, urologist should be able to perform a scrotal ultrasound but, if imaging does not supply a clear diagnosis, surgical exploration is still mandatory.

Cited by 24 publications

References 18 publications

Segmental haemorrhagic infarction of the testis in a paediatric patient: a rare aftermath of epididymitis

Segmental haemorrhagic infarction of the testis in a paediatric patient: a rare aftermath of epididymitis

Pitfalls in Imaging for Acute Scrotal Pathology

Nontraumatic Testicular Pain due to Sacroiliac-Joint Dysfunction: A Case Report

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