Differential Diagnosis for Left Sided Testicular Pain
Single Most Likely Diagnosis
- Epididymitis: This is the most likely diagnosis given the symptoms of left-sided testicular pain without discharge or pain with urination. Epididymitis is an inflammation of the epididymis, usually caused by a bacterial infection, and is characterized by gradual onset of testicular pain, often accompanied by swelling and tenderness of the epididymis.
Other Likely Diagnoses
- Orchitis: Inflammation of one or both testicles, usually caused by viral or bacterial infections. Symptoms can include testicular pain, swelling, and tenderness.
- Testicular torsion (early stages): Although testicular torsion typically presents with sudden, severe pain, early stages might have more subtle symptoms, including intermittent pain.
- Varicocele: Enlargement of the veins within the scrotum, which can cause a dull, aching pain, especially on the left side due to anatomical differences.
Do Not Miss Diagnoses
- Testicular torsion: A medical emergency that requires immediate attention. Even though the pain has been present for 3 days, it's crucial to rule out torsion due to the risk of testicular loss if not treated promptly.
- Testicular cancer: Although less common, testicular cancer can present with pain, and it's essential to consider this diagnosis, especially if there's a palpable mass or significant testicular enlargement.
- Appendicitis (with a retrocecal appendix): In rare cases, appendicitis can present with testicular pain if the appendix is located near the testicles.
Rare Diagnoses
- Spermatocele: A cystic structure filled with sperm, which can cause pain and swelling but is less common.
- Henoch-Schönlein purpura (HSP): A systemic vasculitis that can cause testicular pain, although this is a rare manifestation of the disease.
- Polyarteritis nodosa (PAN): A systemic vasculitis that can affect multiple organs, including the testicles, but is extremely rare.