What are the differential diagnoses for scrotal pain (testicular pain)?

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Achy Testicle Differential Diagnosis

The following is a differential diagnosis for an achy testicle, categorized for clarity and importance.

  • Single most likely diagnosis
    • Epididymitis: This is the most common cause of testicular pain, often resulting from a bacterial infection, usually Chlamydia or Gonorrhea. The pain can be severe and is typically accompanied by swelling of the epididymis.
  • Other Likely diagnoses
    • Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections. It can cause pain, swelling, and may be accompanied by fever.
    • Testicular torsion (early stages): Although it's an emergency, in its early stages, testicular torsion might present with intermittent or mild pain, making it sometimes less immediately recognizable.
    • Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins. It can cause a dull ache or feeling of heaviness in the testicle.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular torsion: This is a medical emergency that requires immediate attention. If not treated promptly, it can lead to the loss of the testicle and potentially long-term fertility issues.
    • Testicular cancer: Although less common, testicular cancer can present with a painless testicular mass, but sometimes it may cause a dull ache. Early detection is crucial for effective treatment.
  • Rare diagnoses
    • Henoch-Schönlein purpura (HSP): A form of vasculitis that can affect various parts of the body, including the testicles, causing pain and swelling.
    • Spermatocele: A cystic structure filled with sperm, which can cause a sensation of heaviness or a dull ache in the testicle.
    • Hydrocele: An accumulation of fluid in the scrotum that can cause swelling and sometimes discomfort or a feeling of heaviness.

Each of these conditions has distinct characteristics, but some may present with similar symptoms, making a thorough medical evaluation essential for an accurate diagnosis and appropriate treatment.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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