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Testicular Torsion | Early Subacute Stage || Ultrasound || Case 358

Clinical Features:
41-year-old male patient came with
Severe right hemiscrotal pain & swelling for around 2 days
No palpable left testis since childhood

Ultrasound Features:
Swollen right testis with inhomogeneously hypoechoic parenchyma & necrotic areas.
Color Doppler shows no detectable flow with in the parenchyma.
A lamellated mass with concentric layering is seen cephalad to the testis representing the coiled spermatic cord components forming the ‘whirlpool sign’ with twisting or whirling on color Doppler.
Right sided reactive hydrocele.
Thickening of the right hemiscrotal skin.
Small & hypoechoic left testis & epididymis with poor vascularity on Doppler.

Remember:
In case of incomplete testicular torsion, color Doppler may show vascularity within the testis.
An increase in arterial RI more than 0.75 & absence of intratesticular venous flow may help confirm testicular torsion.

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