Differential Diagnosis for a 3-year-old Male with Testicle Ascending and Descending
Single most likely diagnosis
- Retractile testis: This condition is common in young boys, where the testicle moves up and down from the scrotum due to an active cremasteric reflex. It is often a normal variant and resolves on its own as the child grows.
Other Likely diagnoses
- Undescended testis (cryptorchidism): A condition where the testicle does not move down into the scrotum, which can be associated with testicular ascent. Treatment is necessary to prevent complications such as infertility and testicular cancer.
- Hydrocele: A condition characterized by fluid accumulation around the testicle, which can cause the testicle to appear to be ascending and descending. It is usually a benign condition that resolves on its own.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Testicular torsion: A medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. It requires immediate surgical intervention to save the testicle.
- Incarcerated inguinal hernia: A condition where a hernia becomes trapped and can cause severe pain, nausea, and vomiting. It requires prompt surgical treatment to prevent complications.
Rare diagnoses
- Testicular ectopia: A rare condition where the testicle is located in an abnormal position, such as in the superficial inguinal pouch or near the pubic bone.
- Polyorchidism: A rare congenital anomaly where a person has more than two testicles, which can be associated with testicular ascent and descent.