Thursday, February 17, 2011

Orchitis in neonates:

This 15 days old male neonate has swelling of the left scrotum. Ultrasound images of the scrotum show a small left hydrocele with thickening of the scrotal wall. See image below:

The left testis also appears to have a shaggy outline suggesting inflammatory pathology of this organ.
Color Doppler image of the left scrotum show minimal increase in flow to the left testis:

However, this sign is not dependable in such young children, due to the poor pick up of color Doppler signals in neonatal scrotum.
Power Doppler study of the scrotum in this infant also proved to be only partially useful- see images below:

Both the above images show only the significant thickening of the left scrotal wall and not so much, the hyperemia.

Only the last image (above) shows some degree of increased flow (power Doppler image) in the left testis, and that too, at the lowest possible PRF (pulse repetition frequency) settings. This helped in ruling out left testicular torsion in this baby. The final diagnosis in this case, based on the ultrasound and color Doppler images above, was left orchitis, although mild in nature.
See this link for more:
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