Orchitis is defined as inflammation of the testis.
Orchitis usually occurs in conjunction with epididymitis.
Bacterial orchitis is usually a secondary infection from epididymitis
and may be a manifestation of a sexually transmitted disease, such
as gonorrhea or chlamydia.
Isolated orchitis is less common and generally is viral (mumps).
Viral causes of orchitis include mumps, influenza, and tonsillitis.
Approximately 20% of prepubertal patients with mumps have orchitis
develop. Orchitis develops in 15% to 25% of men with mumps after
Patients with orchitis may have pain, fever, nausea, and vomiting.
If the disease is left untreated, areas of necrosis or abscess may
Testicular enlargement, decreased echogenicity, and hypervascularity
are all typical findings. In the acute phase of orchitis, the testis
or focal areas of the testis appear less echogenic than a normal
testicle. Increased blood flow from hyperemia may be identified,
and a reactive hydrocele may be present. Hypervascularity may be
the only abnormal finding, so color Doppler analysis is more sensitive
in the diagnosis of orchitis than is gray-scale sonography alone.
In the chronic phase, the testicle appears atrophied with degeneration
of the tubules. The scrotal wall may be thickened with acute or
chronic orchitis. In 60% of patients with orchitis, unilateral testicular
- Testicular Torsion.
- Tumor: diffuse lymphoma or leukemia, and diffuse seminoma and
it is difficult to distinguish a hypoechoic hypervascular tumor
from focal orchitis.
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Kiyo. 2006 Oct;52(10):817-8.
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* 4 Schalamon J, Ainoedhofer H, Schleef J, Singer G, Haxhija EQ,
Hollwarth ME. Management of acute scrotum in children--the impact
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* 5 Stuckmann G. [Ultrasound of the scrotum] Schweiz Rundsch Med
Prax. 2006 May 3;95(18):709-20.
* 6 Vijayaraghavan SB. Sonographic differential diagnosis of acute
scrotum: real-time whirlpool sign, a key sign of torsion. J Ultrasound
Med. 2006 May;25(5):563-74.
* 7 Wittenberg AF, Tobias T, Rzeszotarski M, Minotti AJ. Sonography
of the acute scrotum: the four T's of testicular imaging. Curr Probl
Diagn Radiol. 2006 Jan-Feb;35(1):12-21.
* 8: Philip J, Selvan D, Desmond AD. Mumps orchitis in the non-immune
postpubertal male: a resurgent threat to male fertility? BJU Int.