1. Standard and Additional Imaging for Testes/Scrotum

2. Standard Imaging Protocol
Right and Left Testes
Transverse Images
Epididymal head
Superior testis
Mid with trans measurement
Mid with colour to document blow flow
Inferior testes
Epididymal tail
Longitudinal Images
Lateral testis
Mid
Mid with longitudinal and AP measurement
Medial
Superior Aspect
Inferior Aspect
Right and Left Epididymis
Longitudinal Images with measurement of the thickness of epididymis
Head
Body
Tail
Comparison
Transverse images demonstrating both testes to allow for comparison of echotexture

3. Standard Imaging of the Normal Testes
Images 1-6
Transverse Images of the Testes

10. Standard Imaging of the Normal Testes
Images 7-12
Longitudinal Images of the Testes

17. Standard Imaging of the Normal Testes
Images 13-18
Epididymis

18. Image 13-14: B-mode and Colour Doppler Image of Epididymis Head

19. Image 15-16: B-mode and Colour Doppler Image of Epididymis Body

20. Image 17-18: B-mode and Colour Doppler Image of Epididymis Tail

21. Standard Imaging of the Normal Testes
Images
Comparison Images

22. Image 19-20: B-mode and Colour Doppler Image of both testes
Image 19-20: B-mode and Colour Doppler Image of both testes comparing echotexture and blood flow

23. Altering of Normal Protocol for Pathology
The following is an adaptation of the standard imaging protocol.
The patient was a 24 y/o male with a previous history of right orchidectomy and epididectomy as a result of childhood cryptorchidism and subsequent orchidopexy.
The patient presented with a recurrence of left hydrocoele following surgical drainage four months prior to examination.

24. Adapted Image Protocol for Patient Particulars
Left Testes
Transverse Images
Epididymal head
Superior testis
Mid with trans measurement
Mid with colour to document blow flow
Inferior testes
Epididymal tail
Longitudinal Images
Lateral testis
Mid
Mid with longitudinal and AP measurement
Medial
Superior Aspect
Inferior Aspect
Left Epididymis
Longitudinal Images with measurement of the thickness of epididymis
Head
Body
Tail

40. Additional Imaging Images of relevant pathology including measurements
Upper and lower segments of the apparent hydrocoele
Colour Doppler imaging to assess if any pathological increase in vascularity is present
Image demonstrating communication between superior and inferior segments of the hydrocoele

45. Pathology Identified in this Study
A singular testes is noted.
This is labelled as the left testes according to the patient and previous imaging.
The remaining testicle is enlarged representing compensatory hypertrophy.
There is a hydrocele present. Though several pockets of fluid are seen they appear to be communicating.
Normal vascularity is present within the testes.
No other mass or abnormality is present.
There is no varicocele.

46. Patient Follow Up
This patient returned to the department the following week for drainage of the hydrocele and for injection of a sclerosing agent.