Mirror image artifact - scrotum

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Right scrotal swelling

Patient Data

Age: 55 years
Gender: Male

Scrotum

ultrasound

Moderate right hydrocele with clear fluid.

Few small right epididymal cysts averaging 5 mm.

Case Discussion

The first stack (scanning through right lateral scrotal wall) shows suspected bilateral scrotal hydrocele which confirmed not to be true on scanning through the anterior approach (second stack). The scrotal septum, in our case, acted as a highly reflective surface that formed the false image. To avoid this, scan in different angles and positions to change the angle of insonation.

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