PANCE Genitourinary Practice Test

The key idea is that scrotal ultrasound with color Doppler is the first test to evaluate acute scrotal pain when epididymitis is suspected. It quickly confirms inflammation of the epididymis and, crucially, assesses testicular blood flow to distinguish epididymo-orchitis from testicular torsion, which is an emergency. In epididymitis you’d typically see an enlarged, sometimes heterogeneous epididymis with increased Doppler flow, and you may also observe scrotal wall thickening or a hydrocele. The testis may be normal or mildly involved. Ultrasound is noninvasive, readily available, and free of radiation, making it ideal for urgent evaluation. Other imaging like MRI, pelvic X-ray, or abdominal CT isn’t needed initially because they don’t offer the same rapid, targeted information about scrotal contents and blood flow in this scenario.