From the Research
Yes, epididymitis can be detected on ultrasound, as it is the preferred imaging method for diagnosing this condition, with a sensitivity of 95.9% and specificity of 81.6% for diagnosing acute epididymitis when funiculitis is present 1.
Key Findings
- Ultrasound can clearly show the characteristic findings of epididymitis, including an enlarged and hypervascular epididymis, hypoechoic appearance, and reactive hydrocele or scrotal wall thickening.
- The presence of funiculitis, defined as increased echogenicity of the spermatic cord fat with mass-like cord thickening, has a high sensitivity and specificity for diagnosing acute epididymitis 1.
- Ultrasound is particularly valuable in differentiating epididymitis from other conditions that cause scrotal pain, such as testicular torsion, which requires immediate surgical intervention.
Diagnostic Approach
- If epididymitis is suspected, a healthcare provider will typically order an ultrasound along with urine tests to confirm the diagnosis and determine appropriate antibiotic treatment.
- The procedure is non-invasive, painless, and doesn't use radiation, making it safe and appropriate for evaluating scrotal conditions.
Important Considerations
- While ultrasound is the preferred imaging method, it may not be necessary for follow-up after acute epididymitis in all cases, as most patients can be diagnosed and treated correctly without it 2.
- However, patients with persistent symptoms after antibiotic treatment or those below 50 years of age without bacteriuria should be referred to an urologist for re-evaluation or follow-up ultrasound to rule out underlying testicular cancer.