Sonographically, a torsed testicle appears normal in the first four hours of torsion. Although the realtime appearance of the testes is normal, Color and pulsed-Doppler appearances are abnormal. There is an absence of flow in the testicle and the epididymis. After four hours, the torsed testicle appears enlarged and hypoechoic. The testicle may have some inhomogenous appearances as a result of hemorrhage. Other findings include enlargement of the epidiymis, a reactive hydrocele, and scrotal wall thickening.

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