Contributed by
Children's National Hospital, Washington DC
Sachin Chitalkar, and Dorothy Bulas.
History
A 10-year-old male with Down syndrome presented with intermittent right groin pain for several weeks. Patient was afebrile.
Images (Click any image to enlarge)
Transverse ultrasound grey scale image of both the testicles shows normal echogenicity of both the testicles. There is mildly complex right sided hydrocele.
Ultrasound color and spectral Doppler images show symmetric Doppler vascularity to the testicles with arterial and venous flow documented in the right testicle.
Transverse ultrasound grey scale images of right scrotal sac show heterogeneous hypoechoic region in the center of echogenic tissue with surrounding increased vascularity.
Question
What is the most reasonable diagnosis?
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