Testicular Disorders

Acute Epididymitis

• result of descending infection caused by urinary tract pathogens
• When the infection involves the epididymis and testis (epididymo-orchitis), sonography will frequently show an
  enlarged heterogeneous testis with increased color flow.
• In sexually active men under age 35, acute epididymitis is caused most frequently by Chlamydia trachomatis and less commonly by Neisseria gonorrhoeae.
• Clinical features suggestive of urethritis may be absent (subclinical urethritis). Epididymitis in men who have practiced unprotected insertive rectal intercourse is often caused by Enterobacteriaceae.
• These men usually do not have urethritis but do have bacteriuria. Treatment of acute epididymo-orchitis consists of administering appropriate antibiotics for the treatment of both gonorrhea and Chlamydia infections. 

Testicular Torsion

• Unilateral absent flow on color and spectral Doppler sonography is a highly sensitive and specific finding
• Heterogeneous echotexture of the testis is a common finding in sonograms performed to evaluate acute scrotal pain, regardless of the cause.
• emergent urology referral is indicated