Case 6 :


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A 33-year-old male presents with long-standing scrotal swelling. An MRI is performed following an ultrasound examination of the scrotum. 
What is the diagnosis?

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Imaging findings reveal hetrogenous intensity involving testis and epidydimis, with
enlarged thickened epidydimis with secondary hydrocele.

Chronic epididymitis (tuberculosis)

Epididymitis is typically caused by bacterial organisms associated with urinary tract infections, sexually transmitted diseases (such as chlamydia and gonorrhea), prostatitis (infection of the prostate) or prostatectomy (removal of the prostate). An increased risk is associated with sexually active men who are not monogamous and do not use condoms, and also in patients who have recently had surgery or have a history of structural problems involving the genito-urinary tract.

Clinical Findings
Epididymitis may begin with a low-grade fever and chills and a heavy sensation in the testicle. The testicle becomes increasingly sensitive to pressure or traction. There may be lower abdominal discomfort or pelvic discomfort and urination may cause burning or pain. On occasion there may be a discharge from the urethra, blood in the semen or pain on ejaculation.

Symptoms include painful scrotal swelling, testicular lump, fever, hematuria, and groin pain.



Dr. Deepak Patkar, MRI Centre, Nanavati Hospital, Mumbai