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The clinical, radiological and ultrasound features of 3 patients presenting with tuberculous epididymo-orchitis are described and the relevant literature reviewed. Scrotal swelling, pain and sinuses are common features at presentation. The presence of a sterile pyuria is a useful sign, but intravenous urography may fail to identify active renal disease. Ultrasound examination revealed testicular involvement in 2 patients. Differentiation from tumour may not be possible, but the presence of epididymal involvement strongly suggests an infective cause. Early surgical biopsy may prove helpful if acid-fast bacilli are not initially identified in early morning urine samples.
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