The use of color doppler sonography of the acute scrotum in children

The differential diagnosis of the causes of acute scrotum only by clinical means, is often very difficult and supposes the risk of making mistakes, which leaves to several unnecessary surgical explorations. By Colour Doppler Sonography we get some information about testicular flow that helps us in the diagnosis. During the last two years 72 consecutive cases of acute scrotum in children younger than 13 years old, were seen in our hospital emergency department. They all underwent testicular bilateral sonography with color flow imaging using a 7.5 MHz linear array transducer (Model Sonolayer Toshiba SSH-140 A). The sonographical diagnosis were: 45 epididymo-orchitis (62.5%), 8 testicular torsions (11%), 7 torsions of the appendix of testis (9.7%), 7 normal explorations (9.7%), 4 acute idiopathic scrotal oedema (5.5%) and a Henoch-Schönlein purpura (1.38%). Doppler examination showed a 97.2% sensibility and 72.2% specificity in the diagnosis of epididymo-orchitis and 88.88% sensibility and 100% specificity in the diagnosis of testicular torsion. The Colour Doppler Sonography should not minimize importance to the clinical explorations, but is very useful for the diagnosis of acute scrotal process, overcoat in inflammatory diseases.