Orchitis usually presents with a typical clinical picture.
Obligatory medical device diagnostics.
- Scrotal sonography (ultrasound examination of the scrotal organs (testis and epididymis) and their vasculature) using Doppler sonography (ultrasound examination that can dynamically visualize fluid flows (especially blood flow)):
- In epididymo-orchitis (epididymitis), an inhomogeneously enlarged epididymis and hyperperfusion (increased blood flow) of the testis or epididymis can be demonstrated.
- Testicular torsion (torsion of the testis) is considered proven with evidence of lack of central perfusion (blood flow of central vessels). Furthermore, the testicular vessels (blood vessels of the testis) in the area of the funiculus spermaticus (bundle of vessels, nerves, and the vas deferens) should be visualized. If these present themselves as a spiral in the course, there is also a high probability of testicular torsion (sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, i.e. a positive finding:) 96 %).
- If a mass (testicular tumor with hemorrhage) is present, this is also detectable by sonography.
Doppler sonography of the testis – assessment of central perfusion (modified after).
| Arterial | Negative | positive | positive | |
| Venous | Negative | negative | negative | |
| Further | Central hyperemia | |||
| Diagnosis | No perfusion | Inferior perfusion | Orchitis (testicular inflammation) | Additional information needed: e.g., epididymis, hydatid, tumor |
| Differential diagnoses | Testicular torsion, incarcerated inguinal hernia. | partial torsion of the testis | intermittent testicular torsion |