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Click 50-year-old male with right sided epididymo-orchitis that lead to testicular infarction. Multiple gray scale and color Doppler images were obtained. Pulsewave Doppler images are also provided. The left testicle is normal in size measuring 4.0 x 2.5 x 2.0 cm. Both arterial and venous waveforms are present. Scattered microcalcifications can be seen as well as a discrete calcification measuring up to 1.6 mm. The epididymis has a normal appearance measuring 1.1 x 0.7 cm. A subcentimeter cyst is present within the epididymal head, consistent with a spermatocele. The right testicle is larger than the left and measures 5.0 x 3.1 x 2.8 cm. Both arterial and venous waveforms are present. Mildly increased diffuse flow is present within the testicle. The epididymis is enlarged measuring 1.4 x 1.6 cm with grossly increased blood flow. Mild skin thickening is present. The enlarged and hyperemic right testicle and right epididymis is consistent with epididymo-orchitis. A small hydrocele is seen with mild internal septations. Scattered microcalcifications are present throughout the right testicle.

Click 50-year-old male with right sided epididymo-orchitis that lead to testicular infarction. Multiple gray scale and color Doppler images were obtained. Pulsewave Doppler images are also provided. Within the right scrotum, there has been development of a complex septated hydrocele with low level echoes throughout that has increased in size when compared to the prior examination, consistent with a pyocele. The right epididymis is stable in appearance and hyperemia measuring 1.0 cm x 1.6 cm. The right testicle measures 5.2 cm x 3.7 cm x 2.9 cm. A high resistance wave form with reversal of diastolic flow is demonstrated within the right testicle, which is a sign concerning for impending infarction. The left testicle demonstrates normal arterial and venous blood flow. The left testicle measures 4.1 cm x 2.7 cm x 2.1 cm. The left epdidymis demonstrates normal flow and measures 1.3 cm x 1.3 cm. The left epididymis shows two 5 - 6 mm well defined sonolucencies consistent with spermatoceles. There is a stable calcification in the left testicle. There are no other mass lesions in the left testicle.

Click 50-year-old male with right sided epididymo-orchitis that lead to testicular infarction. Multiple gray scale and color Doppler images were obtained. Pulsewave Doppler images are also provided. The left testicle is normal in size measuring 4.6 cm x 2.7 cm x 2.0 cm. There is normal arterial and venous blood flow. The left epididymis is slightly enlarged by three anechoic cysts likely representing spermatoceles. The left epdidymis measures 1.6 cm x 1.3 cm. The right testicle is heterogeneous and edematous in echotexture with innumerable hyperechoic foci within it. It is enlarged measuring 5.3 cm x 3.3 cm x 2.9 cm. There is no appreciable arterial or venous blood flow consistent with infarction. The right epididymis is heterogeneous in echotexture and edematous in appearance. There is increased color flow to the right epididymis consistent with epidymitis. There is a complex, multiseptated hydrocele on the right, consistent with pyocele.