Urogenital Imaging

Granulomatous epididymitis

granulomatous infection of the epididymis, most often caused by tuberculosis. Epididymitis is commonly associated with prostatitis and orchitis. Clinically, patients with epididymitis present with acute scrotal pain and tenderness, pyrexia, dysuria, pyuria, and urethral discharge. Sonography is useful in excluding testicular torsion, which also presents as acute scrotal pain. The epididymis is seen to be enlarged and often hypoechoic, though acute epididymitis may also be hyperechoic. A reactive hydrocoele is commonly present, and suppuration within the epididymis may spread and result in pyelocoele formation. Focal hypoechoic areas suggest abscess formation. Chronic epididymitis may present as a painless, nodular, palpable mass that is hyperechoic on sonography.

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