Epididymoorchitis Mimicking Testicular Torsion in Henoch-Schönlein Purpura

Henoch-Schönlein purpura, although being a systemic vasculitis, mostly involves skin, gastrointestinal system, joints, and kidneys. Testicular involvement is a rare occurrence. A 7-year-old boy with Henoch-Schönlein purpura developed acute scrotum and was referred to rule out testicular torsion. On gray-scale ultrasonography, the testes and epididymis were slightly enlarged, and had heterogeneous and hypoechoic echotexture. The scrotal wall was thickened as well. Color and power Doppler ultrasonography revealed increased vascularity in scrotal contents. Testicular torsion was excluded and the diagnosis of testicular involvement of Henoch-Schönlein purpura was established. Color Doppler US, together with gray-scale findings, can be useful in the evaluation of Henoch-Schönlein purpura with acute scrotum, excluding testicular torsion and preventing unnecessary surgery.