Thank you for the query.
is and always will be sketchy test and its accuracy depends of the doctors skills and ultrasound unit. That is why it is very hard to tell from this place if your ultrasound is reliable or not.
can be caused by its inflammation, varicocele
(visible in Doppler ultrasound), inguinal hernia, testicle tumors, epididymis
. Ultrasound wont rule all this conditions out. I suggest you to have urine analysis performed, blood work (WBC should be elevated with inflammation), CRP, groin ultrasound and testicle Doppler ultrasound if it was not performed.
Hope this will help.