Testicular torsion occurs in 3.8 per 100,000 boys and is a medical emergency as salvage of the testicle depends on prompt diagnosis and intervention. Testicular torsion has a bimodal distribution, during the perinatal period where the torsion is extravaginal type, and during puberty where the torsion is intravaginal type. Newborns may not have pain related symptoms and perinatal testicular torsion can mimic hernia, tumor or epididymitis. In ultrasound (US), comparison of testicular flow to the contralateral testis may be challenging due to both limitation in detecting testicular blood flow in this age group and that increased peritesticular flow can mimic epididymo-orchitis. We will show rare cases of perinatal testicular torsion with preserved testicular flow. Diagnosing testicular torsion in older age group can be challenging in cases of intermittent testicular torsion or incomplete/partial testicular torsion. Only few children with recurrent hemiscrotal pain have intermittent testicular torsion and US can be normal between the episodes. The purpose of this educational poster is to show limitations and pitfalls of scrotal US in diagnosis of testicular torsion and highlight US features such as spermatic cord whirlpool sign, horizontal testis lie, and epididymal and testicular swelling with normal rather than increased testicular flow. Additionally, we will discuss the potential role of contrast enhanced US that would facilitate timely diagnosis and intervention. We will also show how a swollen and redundant spermatic cord in epididymitis can mimic whirlpool sign as an example of potential pitfall leading to misdiagnosis of testicular torsion. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Chen Paula, Misseri Rosalia, Karmazyn Boaz

Keywords: Ultrasound, Testicular, Torsion

Testicular tumors in children often pose diagnostic challenges. There is a bimodal age distribution and the pathology encountered is age-related. The purpose of this exhibit is to familiarize pediatric radiologists with the types of testicular tumors, the different incidence of malignant tumors among age groups, as well as benign lesions with specific characteristics on ultrasound that do not require surgery. In addition, we will discuss special situations related to specific syndromes such as Peutz-Jeghers and androgen insensitivity syndromes. We will discuss the role of imaging in guiding patient management. 1. Overview of pediatric testicular tumor types by age a. Early childhood, pre-pubertal, pubertal b. Incidence of malignant tumors in each age group 2. Imaging and lab workup of testicular tumors a. US Imaging characteristics of various tumors b. Potential role for contrast enhanced US c. Lab workups d. Indications for abdominal and pelvic CT scans e. Follow up after tumor resection 3. Lesions with specific US characteristics that do not require surgery a. Congenital Adrenal Rests b. Rete testis c. Intratesticular varicose veins 4. Management options a. Radical orchiectomy b. Testicular sparing/Enucleation c. Follow-up 5. Special situations a. Syndromes b. Microlithiasis Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Chen Paula, Marine Megan, Misseri Rosalia, Kaefer Martin, Karmazyn Boaz

Keywords: Testicular tumors, Ultrasound

Evaluate prevalence of clinical occult pyelonephritis in children younger than 7 years with CT diagnosis of pyelonephritis. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Lahiri Niloy, Misseri Rosalia, Steinhardt Nicole, Hains David, Jennings Greg, Karmazyn Boaz

Keywords: Pyelonephritis, CT scan