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Case of the Month

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This is a scrotal ultrasound scan in a 12-year-old boy who presented with a painful right testis. The testis was enlarged, reddened and acutely tender to touch but the spermatic cord was normal. There were no urinary symptoms but there was a past history of bilateral dartos pouch orchidopexies, 6 years earlier, for ectopic testes.

  1. What does the ultrasound show?
  2. What is the differential diagnosis?
  3. What further investigations might be helpful?
  4. What treatment is needed?

Case presented by Mr Nigel Bullock

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