30 year old male with fever and testicular pain.
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Initial ultrasound performed at onset of symptoms was largely unremarkable. The patient returned 3 days later for repeat imaging with increasing symptoms.
Ultrasound through the left testis demonstrates a rounded heterogeneous region, predominantly of low echogenicity, situated towards the upper pole of the left testis, which measures 2.6 x 1.6cm axially x approximately 1.3cm longitudinally. The remainder of the left testis demonstrates normal echogenicity (and comparison with the right demonstrates symmetry between the normal component of the left testis and the right testis). The focal lesion in the left testis demonstrates no evidence of vascular flow centrally within it. There is however, a poorly defined area of increased vascularity in the normal appearing testicular tissue around the focal lesion. Vascularity in the remainder of the left testis and throughout the right testis appears normal. There is only a small hydrocele on the left. The left epididymis appears normal.
Features, in the setting of infective symptoms is consistent with a testicular abscess.
The patient was managed with antibiotics and improved both clinically and on imaging (8 weeks later).