Infectious inflammation of epididymis, testicle, or both
Orchitis alone is much less common than epididymoorchitis
IMAGING
General Features
Ultrasonographic Findings
Fluoroscopic Findings
Nuclear Medicine Findings
MR Findings
Radiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Alshubaili HM et al: Acute right epididymo-orchitis complicated by pampiniform plexus thrombosis. Urol Case Rep. 31:101171, 2020
Devlies W et al: Case report on secondary testicular necrosis due to fulminant epididymitis: ultrasonographic evaluation and diagnosis. BMC Urol. 20(1):115, 2020
Gagliardi L et al: Orchiepididymitis in a boy With COVID-19. Pediatr Infect Dis J. 39(8):e200-2, 2020
Expert Panel on Urological Imaging et al: ACR Appropriateness Criteria® acute onset of scrotal pain-without trauma, without antecedent mass. J Am Coll Radiol. 16(5S):S38-43, 2019
Afsarlar CE et al: Ultrasonographic findings in the epididymis of pediatric patients with testicular torsion. J Pediatr Urol. 13(4):393.e1-6, 2017
Alkhori NA et al: Pediatric scrotal ultrasound: review and update. Pediatr Radiol. 47(9):1125-33, 2017
Hester AG et al: The prostatic utricle: an under-recognized condition resulting in significant morbidity in boys with both hypospadias and normal external genitalia. J Pediatr Urol. 13(5):492.e1-5, 2017
Chang CD et al: Acute epididymo-orchitis-related global testicular infarction: clinical and ultrasound findings with an emphasis on the juxta-epididymal string-of-bead sign. Ultrasound Q. 32(3):283-9, 2016
Cordeiro E et al: Mumps outbreak among highly vaccinated teenagers and children in the central region of Portugal, 2012-2013. Acta Med Port. 28(4):435-41, 2015
Park SJ et al: Distribution of epididymal involvement in mumps epididymo-orchitis. J Ultrasound Med. 34(6):1083-9, 2015
Gkentzis A et al: The aetiology and current management of prepubertal epididymitis. Ann R Coll Surg Engl. 96(3):181-3, 2014
Redshaw JD et al: Epididymitis: a 21-year retrospective review of presentations to an outpatient urology clinic. J Urol. 192(4):1203-7, 2014
Rizvi SA et al: Role of color Doppler ultrasonography in evaluation of scrotal swellings: pattern of disease in 120 patients with review of literature. Urol J. 8(1):60-5, 2011
Jefferies M et al: Fournier's gangrene in a five year old boy - beware of the child post varicella infection. Ann R Coll Surg Engl. 92(5):W62-3, 2010
Muraoka I et al: Acute scrotum caused by vasitis with abscess formation in children with lower urological anomalies. Urology. 76(1):49-52, 2010
Fukuda S et al: Idiopathic testicular infarction in a boy initially suspected to have acute epididymo-orchitis associated with mycoplasma infection and Henoch-Schönlein purpura. J Pediatr Urol. 5(1):68-71, 2009
Lee JC et al: Imaging of the epididymis. Ultrasound Q. 24(1):3-16, 2008
Karmazyn B et al: Duplex sonographic findings in children with torsion of the testicular appendages: overlap with epididymitis and epididymoorchitis. J Pediatr Surg. 41(3):500-4, 2006
Baldisserotto M et al: Color Doppler sonography of normal and torsed testicular appendages in children. AJR Am J Roentgenol. 184(4):1287-92, 2005
Dykes TM et al: Coccidioidomycosis of the epididymis and testis. AJR Am J Roentgenol. 184(2):552-3, 2005
Singh SK et al: Urethrovasocutaneous fistula in a case of anterior urethral stricture. Urol Int. 74(1):86-8, 2005
Akin EA et al: Ultrasound of the scrotum. Ultrasound Q. 20(4):181-200, 2004
Dogra V et al: Acute painful scrotum. Radiol Clin North Am. 42(2):349-63, 2004
Huang LH et al: Diagnosis of Henoch-Schonlein purpura by sonography and radionuclear scanning in a child presenting with bilateral acute scrotum. J Microbiol Immunol Infect. 37(3):192-5, 2004
Ishigami K et al: Enlargement and hypervascularity of both the epididymis and testis do not exclude involvement with lymphoma or leukemia. J Clin Ultrasound. 32(7):365-9, 2004
Jalal H et al: Mumps epididymo-orchitis with prolonged detection of virus in semen and the development of anti-sperm antibodies. J Med Virol. 73(1):147-50, 2004
Lindehall B et al: Complications of clean intermittent catheterization in boys and young males with neurogenic bladder dysfunction. J Urol. 172(4 Pt 2):1686-8, 2004
Somekh E et al: Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol. 171(1):391-4; discussion 394, 2004
Willetts IE et al: Laparoscopic excision of a prostatic utricle in a child. Pediatr Surg Int. 19(7):557-8, 2003
Pimpalwar A et al: Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children. Eur J Pediatr Surg. 12(4):281-5, 2002
Tarantino L et al: Echo color Doppler findings in postpubertal mumps epididymo-orchitis. J Ultrasound Med. 20(11):1189-95, 2001
Bukowski TP et al: Epididymitis in older boys: dysfunctional voiding as an etiology. J Urol. 154(2 Pt 2):762-5, 1995
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Acute scrotum, epididymitis, orchitis, mumps
Definitions
Infectious inflammation of epididymis, testicle, or both
Orchitis alone is much less common than epididymoorchitis
IMAGING
General Features
Ultrasonographic Findings
Fluoroscopic Findings
Nuclear Medicine Findings
MR Findings
Radiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Alshubaili HM et al: Acute right epididymo-orchitis complicated by pampiniform plexus thrombosis. Urol Case Rep. 31:101171, 2020
Devlies W et al: Case report on secondary testicular necrosis due to fulminant epididymitis: ultrasonographic evaluation and diagnosis. BMC Urol. 20(1):115, 2020
Gagliardi L et al: Orchiepididymitis in a boy With COVID-19. Pediatr Infect Dis J. 39(8):e200-2, 2020
Expert Panel on Urological Imaging et al: ACR Appropriateness Criteria® acute onset of scrotal pain-without trauma, without antecedent mass. J Am Coll Radiol. 16(5S):S38-43, 2019
Afsarlar CE et al: Ultrasonographic findings in the epididymis of pediatric patients with testicular torsion. J Pediatr Urol. 13(4):393.e1-6, 2017
Alkhori NA et al: Pediatric scrotal ultrasound: review and update. Pediatr Radiol. 47(9):1125-33, 2017
Hester AG et al: The prostatic utricle: an under-recognized condition resulting in significant morbidity in boys with both hypospadias and normal external genitalia. J Pediatr Urol. 13(5):492.e1-5, 2017
Chang CD et al: Acute epididymo-orchitis-related global testicular infarction: clinical and ultrasound findings with an emphasis on the juxta-epididymal string-of-bead sign. Ultrasound Q. 32(3):283-9, 2016
Cordeiro E et al: Mumps outbreak among highly vaccinated teenagers and children in the central region of Portugal, 2012-2013. Acta Med Port. 28(4):435-41, 2015
Park SJ et al: Distribution of epididymal involvement in mumps epididymo-orchitis. J Ultrasound Med. 34(6):1083-9, 2015
Gkentzis A et al: The aetiology and current management of prepubertal epididymitis. Ann R Coll Surg Engl. 96(3):181-3, 2014
Redshaw JD et al: Epididymitis: a 21-year retrospective review of presentations to an outpatient urology clinic. J Urol. 192(4):1203-7, 2014
Rizvi SA et al: Role of color Doppler ultrasonography in evaluation of scrotal swellings: pattern of disease in 120 patients with review of literature. Urol J. 8(1):60-5, 2011
Jefferies M et al: Fournier's gangrene in a five year old boy - beware of the child post varicella infection. Ann R Coll Surg Engl. 92(5):W62-3, 2010
Muraoka I et al: Acute scrotum caused by vasitis with abscess formation in children with lower urological anomalies. Urology. 76(1):49-52, 2010
Fukuda S et al: Idiopathic testicular infarction in a boy initially suspected to have acute epididymo-orchitis associated with mycoplasma infection and Henoch-Schönlein purpura. J Pediatr Urol. 5(1):68-71, 2009
Lee JC et al: Imaging of the epididymis. Ultrasound Q. 24(1):3-16, 2008
Karmazyn B et al: Duplex sonographic findings in children with torsion of the testicular appendages: overlap with epididymitis and epididymoorchitis. J Pediatr Surg. 41(3):500-4, 2006
Baldisserotto M et al: Color Doppler sonography of normal and torsed testicular appendages in children. AJR Am J Roentgenol. 184(4):1287-92, 2005
Dykes TM et al: Coccidioidomycosis of the epididymis and testis. AJR Am J Roentgenol. 184(2):552-3, 2005
Singh SK et al: Urethrovasocutaneous fistula in a case of anterior urethral stricture. Urol Int. 74(1):86-8, 2005
Akin EA et al: Ultrasound of the scrotum. Ultrasound Q. 20(4):181-200, 2004
Dogra V et al: Acute painful scrotum. Radiol Clin North Am. 42(2):349-63, 2004
Huang LH et al: Diagnosis of Henoch-Schonlein purpura by sonography and radionuclear scanning in a child presenting with bilateral acute scrotum. J Microbiol Immunol Infect. 37(3):192-5, 2004
Ishigami K et al: Enlargement and hypervascularity of both the epididymis and testis do not exclude involvement with lymphoma or leukemia. J Clin Ultrasound. 32(7):365-9, 2004
Jalal H et al: Mumps epididymo-orchitis with prolonged detection of virus in semen and the development of anti-sperm antibodies. J Med Virol. 73(1):147-50, 2004
Lindehall B et al: Complications of clean intermittent catheterization in boys and young males with neurogenic bladder dysfunction. J Urol. 172(4 Pt 2):1686-8, 2004
Somekh E et al: Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol. 171(1):391-4; discussion 394, 2004
Willetts IE et al: Laparoscopic excision of a prostatic utricle in a child. Pediatr Surg Int. 19(7):557-8, 2003
Pimpalwar A et al: Cysts of the ejaculatory system--a treatable cause of recurrent epididymo-orchitis in children. Eur J Pediatr Surg. 12(4):281-5, 2002
Tarantino L et al: Echo color Doppler findings in postpubertal mumps epididymo-orchitis. J Ultrasound Med. 20(11):1189-95, 2001
Bukowski TP et al: Epididymitis in older boys: dysfunctional voiding as an etiology. J Urol. 154(2 Pt 2):762-5, 1995
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