Acute epididymitis in a 9-year-old boy with scrotal pain and redness. Longitudinal US scan shows that the epididymal head and body (arrows) are enlarged and hypoechoic relative to the normal testis (T). Wall thickening (*) and reactive hydrocele (h) are also seen. Power Doppler imaging showed increased perfusion of the epididymis.

http://radiographics.rsna.org/content/25/5/1197.figures-only

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Clinically proved epididymitis in an 11-year-old boy. (a) Longitudinal US scan of the right hemiscrotum shows an enlarged hypoechoic epididymal head (E), reactive hydrocele (h), and thickening of the scrotal wall (*). m = mediastinum. (b) Color and pulsed-wave Doppler image shows increased vascularity in the epididymal head with a low-flow, low-resistance waveform pattern.

http://radiographics.rsna.org/content/25/5/1197.figures-only

Sonographically the acute epididymitis usually shows enlargement of the epididymal head with decreased echogenicity secondary to edema. A reactive hydrocele may be present. Color Doppler findings include an increased amount of flow in and around the epididymis. If an abscess has formed, complex cystic areas may be identified in the epididymis.



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