Differential Diagnosis for 26 yo M with Testicle Pain
- Single most likely diagnosis
- Testicular torsion: This is the most likely diagnosis given the acute onset of testicle pain, tenderness in the right inguinal region, and radiating pain to the right lower quadrant (RLQ). Testicular torsion is a medical emergency that requires prompt attention.
- Other Likely diagnoses
- Epididymitis: Inflammation of the epididymis, usually caused by bacterial infection, can cause testicle pain, swelling, and tenderness. The presence of RLQ tenderness may also be seen in epididymitis due to referred pain.
- Orchitis: Inflammation of the testicle, often caused by viral or bacterial infection, can cause testicle pain, swelling, and tenderness.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Appendicitis: Although the primary symptom is testicle pain, the presence of RLQ tenderness raises the possibility of appendicitis, which can be life-threatening if not treated promptly.
- Ovarian torsion (in females, but can be considered in cases of ambiguous genitalia or other rare conditions): Although the patient is male, it's essential to consider ovarian torsion in cases where the diagnosis is unclear or in individuals with disorders of sex development.
- Ruptured abdominal aortic aneurysm: A rare but life-threatening condition that can cause abdominal and testicle pain due to referred pain.
- Rare diagnoses
- Testicular cancer: Although testicular cancer can cause testicle pain, it is relatively rare and usually presents with a painless testicular mass.
- Henoch-Schönlein purpura (HSP): A rare condition that can cause testicle pain, swelling, and tenderness, often accompanied by abdominal pain, rash, and joint pain.
- Polyarteritis nodosa (PAN): A rare autoimmune disorder that can cause testicle pain, swelling, and tenderness due to inflammation of the blood vessels.