Scrotal wall Diffuse Thickening or Edema sonography

Definition: Diffuse scrotal wall thickening and edema refers to uniform swelling of the scrotal wall layers, often due to accumulation of interstitial fluid and inflammation.

Sonographical Features:
1. Liver size: Normal, measuring ___ cm in craniocaudal length at the mid-clavicular line.
2. Liver echotexture: Homogeneous, normal echogenicity.
3. Intrahepatic biliary radicles: Not dilated.
4. Portal vein: Normal caliber and flow on Doppler.
5. Gallbladder: Well distended, normal wall thickness, no calculi/sludge seen.
6. Common bile duct (CBD): Normal caliber (___ mm).
7. Pancreas: Normal size and echotexture.
8. Spleen: Normal size, measuring ___ cm.

Ultrasound report line (Findings): Scrotal wall appears diffusely thickened, measuring up to 30 mm. Echotexture is hypoechoic with diffuse subcutaneous edema. No focal collection or abscess is identified. Underlying testes and epididymides appear normal in size, echotexture, and vascularity.

Conclusion: Scrotal wall diffuse thickening with edema — likely cellulitis. No evidence of abscess or testicular involvement.

Recommendation: Clinical correlation and follow-up sonography if symptoms persist.

Common Causes:

• Infective: Cellulitis, epididymo-orchitis.
• Inflammatory: Post-traumatic or post-surgical edema.
• Systemic: Heart failure, nephrotic syndrome, liver disease.
• Allergic / idiopathic reactions.

Symptoms:

• Scrotal pain, tenderness, or swelling.
• Redness or warmth over scrotum.
• Heavy dragging sensation.
• Fever or systemic symptoms in infective causes.

Diagnostic Strategy:

• High-resolution gray-scale ultrasound to assess wall thickness and edema pattern.
• Color Doppler study for vascularity and to differentiate cellulitis vs. ischemia.
• Evaluate underlying testes and epididymis to exclude orchitis or abscess.
• Correlate with clinical findings and laboratory tests (CBC, urine, cultures).

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Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. What is the normal scrotal wall thickness on ultrasound? 1. अल्ट्रासाउंड पर सामान्य अंडकोषीय दीवार की मोटाई कितनी होती है?
A. 1–2 mm
B. 2–3 mm
C. 5–7 mm
D. >10 mm

2. Diffuse scrotal wall thickening with hypoechoic edema pattern is most often seen in: 2. हाइपोइकोइक सूजन पैटर्न के साथ अंडकोषीय दीवार की व्यापक मोटाई अक्सर किसमें देखी जाती है?
A. Scrotal cellulitis
B. Testicular tumor
C. Hernia
D. Torsion

3. A honeycomb or reticular pattern in scrotal wall is characteristic of: 3. अंडकोषीय दीवार में हनीकॉम्ब या जालीदार पैटर्न किसका लक्षण है?
A. Hemangioma
B. Severe scrotal wall edema
C. Hydrocele
D. Epididymal cyst

4. Increased vascularity in scrotal wall thickening on Doppler suggests: 4. डॉप्लर पर अंडकोषीय दीवार की मोटाई में बढ़ी हुई रक्त आपूर्ति किसका संकेत है?
A. Systemic edema
B. Inflammatory cellulitis
C. Trauma
D. Normal finding

5. Diffuse scrotal wall thickening without vascularity is more typical of: 5. बिना रक्त आपूर्ति के अंडकोषीय दीवार की व्यापक मोटाई अधिकतर किसमें होती है?
A. Inflammatory cellulitis
B. Systemic edema (CHF, nephrotic syndrome)
C. Abscess
D. Tumor

6. Which of the following is NOT a cause of scrotal wall diffuse thickening? 6. निम्नलिखित में से कौन सा अंडकोषीय दीवार की व्यापक मोटाई का कारण नहीं है?
A. Cellulitis
B. Heart failure
C. Nephrotic syndrome
D. Testicular torsion

7. Which ultrasound feature helps to differentiate scrotal cellulitis from systemic edema? 7. कौन सा अल्ट्रासाउंड लक्षण अंडकोषीय सेल्युलाइटिस और प्रणालीगत सूजन को अलग करता है?
A. Wall thickness
B. Internal vascularity
C. Echotexture
D. Size of testis

8. Which associated condition must always be ruled out in severe scrotal wall edema? 8. गंभीर अंडकोषीय दीवार की सूजन में हमेशा किस स्थिति को बाहर करना चाहिए?
A. Fournier’s gangrene
B. Hydrocele
C. Inguinal hernia
D. Tumor

9. In scrotal wall edema due to nephrotic syndrome, Doppler usually shows: 9. नेफ्रोटिक सिंड्रोम के कारण अंडकोषीय दीवार की सूजन में डॉप्लर आमतौर पर क्या दिखाता है?
A. Increased vascularity
B. Absent internal vascularity
C. Arterial turbulence
D. Phleboliths

10. Which of the following is a key sonographic clue to scrotal cellulitis? 10. निम्नलिखित में से कौन सा अंडकोषीय सेल्युलाइटिस का प्रमुख सोनोग्राफिक संकेत है?
A. Diffuse wall thickening with increased vascularity
B. Hyperechoic parenchyma
C. Multiple cysts
D. Hydrocele with septations