http://www.ultrasoundpaedia.com/normal-scrotal/Extratesticular Lump or swelling Hydrocele Epididymitis, Orchitis or Epididymo-orchitis Epididymal Cysts Varicocele in the Pampiniform plexus Cryptorchidism or Maldescent Scrotal "Pearl" Microlithiasis (intratesticular)Scrotal swelling with pain -4 main causes: Torsion (20%) Infection/inflammation (75-80%) Haemorrhage Strangulated HerniaTorsion results in acute testicular infarction and eventually an atrophic testicle and constitutes a medical emergency. Quite often these patients will bypass the imaging department and go straight to theatre.NOTE: epididymitis:torsion = 3:2 20yearsIntratesticular Lumps Germ Cell Tumours Seminoma Nonseminoma