The testicular scan and ultrasonography in the diagnosis of acute scrotal pain

Lee, Sang Kon; Yun, Taek Hong; Choi, Nak Gyeu

Abstract

A diagnostic accuracy was evaluated in total of 65 patients with acute painful scrotal swelling who underwent ultasonography and/or radionuclide scrotal imaging as an initial diagnostic modality. An accuracy with radionuclide scrotal imaging was 77.8% (7/9) in patients with testicular torsion. 92.0% (23,25) in those with epididymoorchitis. Ultasonography showed the diagnostic accuracy of 100% (15,15) in patients with epididymoorchitis. 66.7% (2/3) in those with testicular torsion and 87.5% (14,16) in those with scrotal trauma. One patient with the torsion of appendix testis was not diagnosed by radionuclide scrotal imaging preoperatively. Two of 8 patients (25%) with testis rupture were misdiagnosed by ultrasonography. Scrotal ultrasonography and nuclear medicine scan are useful adjuncts in diagnosis of torsion of appendix testis and testicular abscess. A possibility of misleading for diagnosis should not be overlooked. Scrotal exploration is mandatory in patients whose clinical pictures are not correlated with radiographic findings.