DDX of acute scrotum

Approach to the DDX of the acute scrotum:

  • Ultrasound is the primary modality in the assessment of the acute scrotum
  • Testicle torsion is diagnosed by the absence of arterial blood flow via color and spectral doppler US in the testicle
  • Torsion of the appendix testis is most often a clinical diagnosis (blue dot on scrotum) and is diagnosed by the absence of arterial blood flow via color and spectral doppler US in the appendix testis
  • Epididimo-orchitis is diagnosed by increased arterial blood flow to the epididymis and or testicle by color doppler US
  • Inguinal hernia is diagnosed when bowel loops are seen in the scrotum
  • Hydrocele is diagnosed when anechoic fluid is seen in the scrotum
  • Testicle tumor is an intratesticular mass
  • Testicle trauma has a variable appearance in the right clinical setting