Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Scrotal Sonography
(Left) Transverse grayscale
ultrasound of the scrotum
shows an abnormal axis of the
left testis ſt compared to the
right. Patient was confirmed
to have acute left testicular
torsion. Torsed testis may
change its axis and be located
more horizontally. (Right)
Transverse color Doppler
ultrasound of bilateral testes
shows a complete absence of
flow in the right testis,
suggestive of acute testicular
torsion. It is important to
examine both testes using the
same color scale st and same
color Doppler gain settings.
Diagnoses: Scrotum
(Left) Evaluation of both
testes side by side using the
same scale is essential to
detect slight asymmetry in
blood flow. This patient shows
decreased flow on the right
side ſt, surgically confirmed
to be right-sided partial
testicular torsion. (Right) Color
Doppler ultrasound of the left
testis demonstrates hyperemia
ſt of the testis and
epididymis, along with
associated complex hydrocele
and skin thickening st.
Findings suggest acute
epididymoorchitis in the
setting of acute left-sided
pain.
(Left) Color Doppler
ultrasound of bilateral
epididymal tails shows
enlarged right epididymis with
increased blood flow ſt.
Comparison of both sides
using the same scale is
essential to detect asymmetry
in size and vascularity. (Right)
Color Doppler ultrasound of
testes in the same patient
shows increased blood flow on
the right side ſt. In a patient
with acute right-sided pain,
findings suggest acute
epididymoorchitis.
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