Background: Ultrasound is the primary modality for the evaluation of patients with acute scrotum. Accurate exclusion of testicular torsion is prevented from unnecessary surgical exploration. Objectives: We assessed scrotal changes in pediatric testicular torsion in comparison epidydimits, with purpose to determine more specific points for differentiation testicular torsion from epididymitis. Methods: During 2011 -2017 a descriptive case control study was performed in Dr. Sheikh and Akbar Children hospital, Mashhad medical university of science. The 41 pediatric patients with acute scrotum (21 cases with testicular torsion and 20 cases with epididymitis) were examined. Eventually, the sonographic findings were analyzed to compare the results. Results: Testicular and epididymal enlargement, hydrocele, the hyperemia of surrounding tissues and the scrotal skin thickening
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