A male with a hypercoagulable state may infarct a testis.
Clinical features:
(1) testicular pain, usually unilateral
(2) hypercoagulable state, untreated or inadequately treated
(3) presence or absence of a precipitating event such as trauma
Imaging studies:
(1) The appearance on ultrasonography is similar to torsion, with absence of blood flow and increased echogenicity.
Laboratory findings:
(1) The findings depend on the underlying hypercoagulable state (deficiency in protein S or protein C, Factor V Leiden, etc)
(2) The testis shows hemorrhagic necrosis.
Differential diagnosis:
(1) testicular torsion
(2) trauma
(3) embolic disease
