Orchitis. Once the infection has spread to the testicle, it is termed orchitis. The testicle may appear normal or enlarged in size and the echogenicity may be decreased or heterogeneous. Reactive hydroceles and skin thickening are associated with orchitis. As in many infections, there will be increased color Dopplor flow to the infected testes. Chronic orchitis appears as layers of heterogeneous disruption within the testicle. Focal orchitis may occur without involvement of the epididymis and has the same appearance as a neoplasm, although clinical symptoms such as fever and increased white blood cell count strongly would suggest an infectious process.


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