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A 36-year-old male is seen , of severe scrotal pain.Mumps parotitis appeared 7days ago. Patient âgé de 36 ans présentant une douleur scrotale. Il a présenté une parotidite ourlienne il y a 7 jours.

Inflammation of the right testis due to the mumps virus. Testicular enlargement, decreased echogenicity, and hypervascularity are all typical findings. Inflammation du testicule droit due au virus de l'oreillon. .L'élargissement testiculaire, L'hypoéchogènicité, et l' Hypervascularisation sont tous les signes typiques de l'orchite.
Viral Orchitis (mumps)
Orchite Virale (ourlienne)




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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 puberty.

Clinical :
Patients with orchitis may have pain, fever, nausea, and vomiting. If the disease is left untreated, areas of necrosis or abscess may develop.

Ultrasonography :
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 atrophy occurs.

Differentials :
- Epididymitis.
- Hernias.
- Testicular Torsion.
- Trauma.
- Tumor: diffuse lymphoma or leukemia, and diffuse seminoma and it is difficult to distinguish a hypoechoic hypervascular tumor from focal orchitis.

Reference :
* 1 Tomita Y, Nemoto K. [A case of granulomatous orchitis] Hinyokika Kiyo. 2006 Oct;52(10):817-8.
* 2 Nikolic O, Lukac I. Doppler sonography in diagnosis of the acute scrotum. Med Pregl. 2006 Mar-Apr;59(3-4):111-7.
* 3 Feole JB, Lee FT Jr. Doppler sonography in testicular and scrotal imaging. Curr Opin Urol. 1998 Mar;8(2):87-94.
* 4 Schalamon J, Ainoedhofer H, Schleef J, Singer G, Haxhija EQ, Hollwarth ME. Management of acute scrotum in children--the impact of Doppler ultrasound. J Pediatr Surg. 2006 Aug;41(8):1377-80.
* 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. 2006 Jan;97(1):138-41.




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