Orchitis
Citation, DOI, disclosures and article data
Citation:
Bickle I, Elfeky M, Jones J, et al. Orchitis. Reference article, Radiopaedia.org (Accessed on 23 Mar 2025) https://doi.org/10.53347/rID-21524
rID:
21524
Article created:
Disclosures:
At the time the article was created Ian Bickle had no recorded disclosures.
View Ian Bickle's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Mostafa Elfeky had no financial relationships to ineligible companies to disclose.
View Mostafa Elfeky's current disclosures
Revisions:
19 times, by
17 contributors -
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Systems:
Tags:
Synonyms:
- Orchitides
- Isolated orchitis
Orchitis (plural: orchitides) is an infection of the testis, which is rarely isolated, and when in conjunction with the epididymis is called epididymo-orchitis.
On this page:
Pathology
Usually, bacteria retrogradely seed into the testis from the bladder or prostate. It can also be secondary to viral infection (e.g. mumps, Coxsackie virus).
Associations
- almost all cases are associated with epididymitis
- isolated orchitis can be seen in mumps, syphilis and brucellosis 6
Radiographic features
Ultrasound
Ultrasound is the gold standard investigation. When compared with the other testis in the 'sunglasses view' features of orchitis include relative:
- hypoechogenicity: focal or diffuse
- hypervascularity: focal or diffuse
- swelling
- scrotal wall thickening
A complex/septated hydrocele can be seen in the ipsilateral scrotum.
Differential diagnosis
- intermittent testicular torsion 5
- reperfusion after intermittent torsion can present similarly on Doppler ultrasound with increased flow, but the patient's history allows differentiation
- primary testicular malignancy should be considered, especially with focal changes
Quiz questions
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References
- 1. Başekim C, Kizilkaya E, Pekkafali Z, Baykal K, Karsli A. Mumps Epididymo-Orchitis: Sonography and Color Doppler Sonographic Findings. Abdom Imaging. 2000;25(3):322-5. doi:10.1007/s002610000039
- 2. Michaelides M, Sotiriadis C, Konstantinou D, Pervana S, Tsitouridis I. Tuberculous Orchitis US and MRI Findings. Correlation with Histopathological Findings. Hippokratia. 2010;14(4):297-9. PMC3031331
- 3. Syed Z.H. Jafri, Ananias C. Diokno, Marco A. Amendola. Lower Genitourinary Radiology. (1997) ISBN: 9780387947068 - Google Books
- 4. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438 - Google Books
- 5. Alexander L, Caserta M, Baden K, Livingston D, Cernigliaro J, Bhatt S. Absent, Abnormal, or Reduced Flow in the Testis: Thinking Beyond Torsion. Radiographics. 2020;40(2):529-30. doi:10.1148/rg.2020190111
- 6. Baykan A, Sayiner H, Inan I. Brucella and Non-Brucella Epididymo-Orchitis: Comparison of Ultrasound Findings. Med Ultrason. 2019;21(3):246. doi:10.11152/mu-1871
Incoming Links
Articles:
- Testes
- Heterogeneous testicular echotexture
- Unilateral testicular lesions
- Scrotal infections
- Granulomatous epididymitis
- Hematospermia
- Testicular lymphoma
- Abnormal testicular Doppler flow (differential)
- Scrotum
- Vasitis
- Brucellosis
- Epididymitis
- Testicular seminoma
- Testicular vasculitis
- Risk factors for testicular germ cell tumors
- Striated testis
- Male breast cancer
Cases:
- Testicular abscesses
- Vasitis
- Post-traumatic scrotal cellulitis and orchitis
- Epididymo-orchitis - acute
- Epididymal abscess
- Epididymo-orchitis and distal funiculitis with possible pyocele formation
- Acute left epididymo-orchitis
- Epididymo-orchitis
- Testicular lymphoma
- Epididymo-orchitis
- Testicular abscess and pyocoele
- Epididymo-orchitis with background microlithiasis
- Striated testis - orchitis
- Reperfusion testicular hyperaemia post torsion correction
- Epididymo-orchitis
- Orchitis - unilateral
- Isolated orchitis
- Hydrocele of spermatic cord and of tunica vaginalis
- Acute orchitis with pyocele
- Epididymo-orchitis
Multiple choice questions:
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