torsed appendix testes

  I recently found a pea sized lump on the top of left testicle, about an eighth of an inch from the epiditymis. My ultra-sound showed nothing, but my urologist told me it was a torsed appendix testes.  that there were like five positions on the testicle that they can appear and this one had no name, but that's what it is. They also took a urine sample that was fine.  Is it unlikely that is what this is since you said they are rarely palpable. Or does everyone have them and only some can feel it?  He said that even the size of a BB or pea was too small to show up on an ultra sound.  Is this a viable prognosis??

[HFHS M.D.-CK]

_
Dear scott,
The appendix testes is a normal remnant of tissue attached to the testicle.  During development certain tissue in males regresses, and the function of an appendix testes in males is unknown.  A problem can occur if the appendix testes twists (torsion) and chokes off its blood supply.  Although it is a tiny amount of  tissue, considerable pain is experienced.  
To diagnose torsion of the appendix testes considerable clinical suspicion is necessary.  Torsion of the testicle itself must be ruled out.  Sometimes in fair skinned men or boys a "blue dot" of tissue is seen through the scrotal skin indicating a lack of blood flow to the appendix testes.  Ultrasound examination may not always visualize this structure.  Ultrasound may identify secondary inflammatory changes including a build-up of fluid.  The treatment includes anti-inflammatory medications, scrotal support, and avoiding strenuous activities.  Warm tub soaks may also provide releif.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
  Sincerely,
  HFHS M.D.-CK
  *keyword:appendix testes