UNTIL approximately five years ago, no imaging procedures existed to assist in the evaluation of acute scrotal swelling, with or without pain or tenderness. The introduction and development of testicular radionuclide angiography and scrotal scanning1 have provided a highly reliable technique that is used primarily in the differentiation of acute epididymitis from torsion of the testis. The timely use of this procedure obviates surgical exploration, when instead antibacterial and anti-inflammatory therapy should be instituted, and points to expedient surgical intervention in the case of the salvable ischemic testis.
This radionuclide examination can be performed in any hospital with conventional imaging equipment. The technical details of this study have been presented elsewhere.2 After careful palpation of the scrotum and localization of any swelling, the gamma camera, equipped with a converging collimator, is positioned closely over the scrotum. The entire examination can be performed in approximately 15 minutes, entailing