Differential Diagnosis for Passive Testicular Pain
Single Most Likely Diagnosis
- Epididymitis: This is the most common cause of passive testicular pain, often resulting from a bacterial infection, typically Chlamydia or Gonorrhea. The pain is usually gradual in onset and can be accompanied by other symptoms such as swelling, redness, and discharge.
Other Likely Diagnoses
- Orchitis: Inflammation of one or both testicles, usually caused by viral or bacterial infections. It can present with pain, swelling, and tenderness of the testicles.
- Testicular torsion (partial or intermittent): Although testicular torsion typically presents with acute, severe pain, partial or intermittent torsion can cause passive pain. It's a condition where the spermatic cord becomes twisted, cutting off the blood supply to the testicle.
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins. It can cause a dull, aching pain, especially after long periods of standing.
Do Not Miss Diagnoses
- Testicular cancer: Although rare, testicular cancer can present with a painless testicular mass or, less commonly, with pain. Early detection is crucial for effective treatment.
- Appendicitis (with a retrocecal appendix): In some cases, an inflamed appendix located behind the cecum can irritate the testicle, causing referred pain.
- Kidney stones: Stones in the urinary tract can cause severe pain, which may radiate to the testicles.
Rare Diagnoses
- Spermatocele: A cystic structure filled with sperm, which can cause a painless or mildly painful mass but is rarely associated with significant pain.
- Henoch-Schönlein purpura: A form of vasculitis that can cause testicular pain, along with other symptoms like rash, joint pain, and gastrointestinal issues.
- Polyarteritis nodosa: A systemic vasculitis that can affect various organs, including the testicles, causing pain and other symptoms.