Case 36

Ok, this was a “fun” one. Definitely not something we see every day which is why I saved it till the end of the year. 

I got hernia several times, and yes, that would be a good thought but remember to use the limited history you get…. no motion… ie no peristalsis. And there is a lot of vascularity as well. So what else could give you an elongated heterogeneous hypervascular mass in the inguinal canal? It’s been going on for 3-4 weeks now.  The testicle is ok, but there is a hydrocoele.

Answer: infection of the spermatic cord.  aka  funiculitis

After a decent amount of googling, there isn’t a very good write-up on this, beyond it being worsening of epididymitis - so cord thickening, hyperemia and often with reactive fluid/hydrocoele. 

here is another case with a similar appearance:  https://radiopaedia.org/cases/funiculitis