Artwork

Sisällön tarjoaa Daniel J. Kowal, MD, Daniel J. Kowal, and MD. Daniel J. Kowal, MD, Daniel J. Kowal, and MD tai sen podcast-alustan kumppani lataa ja toimittaa kaiken podcast-sisällön, mukaan lukien jaksot, grafiikat ja podcast-kuvaukset. Jos uskot jonkun käyttävän tekijänoikeudella suojattua teostasi ilman lupaasi, voit seurata tässä https://fi.player.fm/legal kuvattua prosessia.
Player FM - Podcast-sovellus
Siirry offline-tilaan Player FM avulla!

Case Review: Ultrasound of Torsion of the Appendix Testis

10:06
 
Jaa
 

Arkistoidut sarjat ("Toimeton syöte" status)

When? This feed was archived on April 26, 2023 20:55 (11M ago). Last successful fetch was on March 21, 2023 15:14 (1y ago)

Why? Toimeton syöte status. Palvelimemme eivät voineet hakea voimassa olevaa podcast-syötettä tietyltä ajanjaksolta.

What now? You might be able to find a more up-to-date version using the search function. This series will no longer be checked for updates. If you believe this to be in error, please check if the publisher's feed link below is valid and contact support to request the feed be restored or if you have any other concerns about this.

Manage episode 352923717 series 1282250
Sisällön tarjoaa Daniel J. Kowal, MD, Daniel J. Kowal, and MD. Daniel J. Kowal, MD, Daniel J. Kowal, and MD tai sen podcast-alustan kumppani lataa ja toimittaa kaiken podcast-sisällön, mukaan lukien jaksot, grafiikat ja podcast-kuvaukset. Jos uskot jonkun käyttävän tekijänoikeudella suojattua teostasi ilman lupaasi, voit seurata tässä https://fi.player.fm/legal kuvattua prosessia.

In this radiology lecture, we review the ultrasound appearance of torsion of the appendix testis and appendix epididymis!

Key teaching points include:

  • Appendix testis is a vestigial appendage usually located between upper pole of testis and head of epididymis.
  • AKA hydatid of Morgagni, the appendix testis is commonly present as a normal finding.
  • Appendix epididymis typically arises from epididymal head.
  • Both scrotal appendages are often pedunculated which increases risk of torsion.
  • Torsion occurs when appendage twists, occluding blood supply.
  • Torsion of the appendix testis is one of most common causes of acute scrotal pain in prepubertal children.
  • Peak age 7-12 years old, but can occur at any age.
  • Normal appendix testis: Oval-shaped, less than 6 mm in size, homogeneously isoechoic to epididymis, and demonstrates little to no blood flow on color Doppler.
  • Torsed appendix testis: 6 mm or larger in size, variable echogenicity, hypoechoic before 24 hours, hyperechoic or heterogeneous after 24 hours.
  • In setting of appendix torsion, hyperemia of surrounding structures with hydrocele and scrotal wall thickening often present.
  • Torsed appendage can detach and become free floating in scrotum.
  • Patients may present with pain localized to upper pole of testis or epididymis.
  • Physical examination may yield the “blue dot” sign: Small, palpable nodule at superior aspect of testis with bluish discoloration of overlying skin due to ischemic appendix.
  • Cremasteric reflex typically intact, and testicle not high riding (unlike testicular torsion).
  • Hyperemia of surrounding structures can be difficult to differentiate from bacterial epididymitis.
  • However, in children, epididymitis usually secondary to inflammation from direct trauma, torsion of a scrotal appendage, or urine reflux into epididymis. Urine dipstick/urinalysis helpful to differentiate from infection.
  • Treatment: Pain management with analgesics, ice, rest. If not recognized, may be treated unnecessarily with antibiotics. Scrotal exploration may be necessary if testicular torsion cannot be excluded.

References:
Baldisserotto M, Ketzer de Souza JC, Pertence AP, Dora MD. Color Doppler sonography of normal and torsed testicular appendages in children. AJR 2005; 184:1287–1292

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

Website: https://radiologisthq.com/
Spotify Video Podcast: https://bit.ly/spotify-rhq
Instagram: https://www.instagram.com/radiologistHQ/
Facebook: https://www.facebook.com/radiologistHeadQuarters/
Twitter: https://twitter.com/radiologistHQ
Reddit: https://www.reddit.com/user/radiologistHQ/

The post Case Review: Ultrasound of Torsion of the Appendix Testis appeared first on Radiologist Headquarters.

  continue reading

81 jaksoa

Artwork
iconJaa
 

Arkistoidut sarjat ("Toimeton syöte" status)

When? This feed was archived on April 26, 2023 20:55 (11M ago). Last successful fetch was on March 21, 2023 15:14 (1y ago)

Why? Toimeton syöte status. Palvelimemme eivät voineet hakea voimassa olevaa podcast-syötettä tietyltä ajanjaksolta.

What now? You might be able to find a more up-to-date version using the search function. This series will no longer be checked for updates. If you believe this to be in error, please check if the publisher's feed link below is valid and contact support to request the feed be restored or if you have any other concerns about this.

Manage episode 352923717 series 1282250
Sisällön tarjoaa Daniel J. Kowal, MD, Daniel J. Kowal, and MD. Daniel J. Kowal, MD, Daniel J. Kowal, and MD tai sen podcast-alustan kumppani lataa ja toimittaa kaiken podcast-sisällön, mukaan lukien jaksot, grafiikat ja podcast-kuvaukset. Jos uskot jonkun käyttävän tekijänoikeudella suojattua teostasi ilman lupaasi, voit seurata tässä https://fi.player.fm/legal kuvattua prosessia.

In this radiology lecture, we review the ultrasound appearance of torsion of the appendix testis and appendix epididymis!

Key teaching points include:

  • Appendix testis is a vestigial appendage usually located between upper pole of testis and head of epididymis.
  • AKA hydatid of Morgagni, the appendix testis is commonly present as a normal finding.
  • Appendix epididymis typically arises from epididymal head.
  • Both scrotal appendages are often pedunculated which increases risk of torsion.
  • Torsion occurs when appendage twists, occluding blood supply.
  • Torsion of the appendix testis is one of most common causes of acute scrotal pain in prepubertal children.
  • Peak age 7-12 years old, but can occur at any age.
  • Normal appendix testis: Oval-shaped, less than 6 mm in size, homogeneously isoechoic to epididymis, and demonstrates little to no blood flow on color Doppler.
  • Torsed appendix testis: 6 mm or larger in size, variable echogenicity, hypoechoic before 24 hours, hyperechoic or heterogeneous after 24 hours.
  • In setting of appendix torsion, hyperemia of surrounding structures with hydrocele and scrotal wall thickening often present.
  • Torsed appendage can detach and become free floating in scrotum.
  • Patients may present with pain localized to upper pole of testis or epididymis.
  • Physical examination may yield the “blue dot” sign: Small, palpable nodule at superior aspect of testis with bluish discoloration of overlying skin due to ischemic appendix.
  • Cremasteric reflex typically intact, and testicle not high riding (unlike testicular torsion).
  • Hyperemia of surrounding structures can be difficult to differentiate from bacterial epididymitis.
  • However, in children, epididymitis usually secondary to inflammation from direct trauma, torsion of a scrotal appendage, or urine reflux into epididymis. Urine dipstick/urinalysis helpful to differentiate from infection.
  • Treatment: Pain management with analgesics, ice, rest. If not recognized, may be treated unnecessarily with antibiotics. Scrotal exploration may be necessary if testicular torsion cannot be excluded.

References:
Baldisserotto M, Ketzer de Souza JC, Pertence AP, Dora MD. Color Doppler sonography of normal and torsed testicular appendages in children. AJR 2005; 184:1287–1292

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4

Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week!

Website: https://radiologisthq.com/
Spotify Video Podcast: https://bit.ly/spotify-rhq
Instagram: https://www.instagram.com/radiologistHQ/
Facebook: https://www.facebook.com/radiologistHeadQuarters/
Twitter: https://twitter.com/radiologistHQ
Reddit: https://www.reddit.com/user/radiologistHQ/

The post Case Review: Ultrasound of Torsion of the Appendix Testis appeared first on Radiologist Headquarters.

  continue reading

81 jaksoa

Kaikki jaksot

×
 
Loading …

Tervetuloa Player FM:n!

Player FM skannaa verkkoa löytääkseen korkealaatuisia podcasteja, joista voit nauttia juuri nyt. Se on paras podcast-sovellus ja toimii Androidilla, iPhonela, ja verkossa. Rekisteröidy sykronoidaksesi tilaukset laitteiden välillä.

 

Pikakäyttöopas