Scrotum and Prostate - Part 5 Flashcards
What causes a hematocele? (2)
- Trauma
2. Ruptured varicocele
What are the clinical findings of a hematocele? (2)
- Scrotal pain
2. Scrotal mass
What is the US appearance of hematocele? (2)
- Anechoic with swirling echoes
2. Thickened wall with septations when chronic
What are 3 differential diagnosis of a hematocele?
- Chronic hydrocele
- Loculated hydrocele
- Testicular torsion
What causes a hernia?
Weak abdominal wall muscles
Where can inguinal hernias extend into?
Into the scrotum
What are the clinical findings of a hernia? (2)
- Scrotal mass
2. Abdominal pain
What is the US appearance of a hernia? (3)
- Complex extratesticular mass
- Mass can be traced to the inguinal canal
- Peristalsis may be noted
What are 2 differential diagnosis of a hernia?
- Testicular torsion
2. Hematocele
What causes a hydrocele? (3)
- Inflammation
- Idiopathic
- Congenital
What is a hydrocele associated with a hydrocele? (3)
- Torsion
- Trauma
- Malignancy
What are the clinical findings of a hydrocele? (4)
- Enlarged scrotum
- Asymptomatic
- Scrotal mass
- Scrotal pain
What is the US appearance of a hydrocele? (5)
- Anechoic fluid collection lateral and anterior to the testis
- Strong posterior acoustic enhancement
- Thin scrotal wall when acute
- Diffuse wall thickening when chronic
- May demonstrate internal echoes or septations
What are 4 differential diagnosis of a hydrocele?
- Epididymal cyst
- Spermatocele
- Hematocele
- Hernia
What are causes of a varicocele? (2)
- Idiopathic
- Incompetent valves in the
spermatic vein
What are the clinical findings for a varicocele? (4)
- Asymptomatic
- Infertility
- Tender scrotal
mass - Scrotal ache
What is the US appearance for a varicocele? (2)
- Tortuous venous structures exceeding 4mm in diameter
2. Veins increase in size with Valsalva maneuver or while patient is standing
What are 2 differential diagnosis for a varicocele?
- Loculated hydrocele
2. Epididymal cyst
What is the most common place for the location of a varicocele?
On the left and in the inferior portion of the scrotum
What is the most common benign tumour of the epididymis?
Adenomatoid tumour
What is a clinical finding of a adenomatoid tumour?
Asymptomatic
What is the US appearance of a adenomatoid tumour? (2)
- Variable echogenicity from hypo to hyper echoic
- Small in size
- less than 2cm
What is a differential diagnosis of a adenomatoid tumour?
Focal epididymitis
What is a cause of a epididymal cyst?
Vasectomy
What are the clinical findings of an epididymal cyst? (2)
- Asymptomatic
2. Palpable scrotal mass
What is the US appearance of an epididymal cyst? (2)
- Anechoic mass in the epididymis
2. Compression of the testis
What are 3 differential diagnosis of an epididymal cyst?
- Spermatocele
- Loculated hydrocele
- Varicocele
What are the causes of epididymitis? (3)
- Lower urinary infection
- Idiopathic
- Trauma
What are the clinical findings of epididymitis? (5)
- Acute scrotal pain 2. Swelling
- Leukocytosis
- Fever
- Dysuria
What is the US appearance of epididymitis? (4)
- Enlarged hypo echoic epididymis
- Hypervascular epididymis
- Hyper echoic with calcifications when chronic
- Small cysts may be visualized
What are 2 differential diagnosis of epididymitis?
- Testicular torsion
2. Varicocele
What are the causes of spermatocele? (4)
- Retention cyst arising from the rete testis
- Idiopathic
- Infection
- Trauma
What are the clinical findings of a spermatocele? (2)
- Asymptomatic
2. Palpable scrotal mass
What is the US appearance of a spermatocele? (4)
- Anechoic mass lying superior to the testis
- Round or oval in shape
- Does not compress testis
- Generally solitary
What are 2 differential diagnosis of a spermatocele?
- Loculated hydrocele
2. Epididymal cyst