The fountain sign: a novel color Doppler sonographic finding for the diagnosis of acute idiopathic scrotal edema.

OBJECTIVE

Acute idiopathic scrotal edema (AISE) is an important differential diagnosis in children presenting with an acute scrotum. Sonography plays an important role in excluding testicular torsion, epididymitis, and torsion of a testicular appendage and confirming the diagnosis of AISE. The purpose of this series was to evaluate the relevance of color Doppler sonography (CDS) in children presenting with AISE.

METHODS

Ten patients with AISE who underwent CDS during a 25-month period were retrospectively analyzed with regard to typical sonographic findings distinguishing AISE from other causes of scrotal edema.

RESULTS

Marked bilateral scrotal wall thickening and hyperemia resembling a fountain were detected in the transverse plane on CDS in all patients.

CONCLUSIONS

This report highlights the usefulness of CDS in diagnosing AISE by showing that the "fountain sign" is related to hypervascularity of the scrotal wall. In an acute scrotum, this sign may help differentiate AISE from other etiologies.