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Differential Diagnosis for Testicular Pain

  • Single most likely diagnosis
    • Epididymitis: This is the most common cause of testicular pain, especially in sexually active young men. It is usually caused by a bacterial infection, such as chlamydia or gonorrhea, and is characterized by pain, swelling, and inflammation of the epididymis.
  • Other Likely diagnoses
    • Testicular torsion: Although less common, testicular torsion is a significant cause of testicular pain, especially in adolescents and young adults. It occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle.
    • Orchitis: This is an inflammation of one or both testicles, usually caused by a viral or bacterial infection. It can cause pain, swelling, and tenderness in the testicles.
    • Varicocele: A varicocele is an enlargement of the veins within the scrotum, similar to varicose veins. It can cause a dull, aching pain in the testicle and is more common on the left side.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular cancer: Although rare, testicular cancer can cause testicular pain, and early detection is crucial for effective treatment.
    • Appendicitis (with referred pain): In some cases, appendicitis can cause referred pain to the testicles, especially if the appendix is located near the testicles.
    • Kidney stones: Kidney stones can cause severe pain that radiates to the testicles, especially if the stone is located in the lower ureter.
  • Rare diagnoses
    • Henoch-Schönlein purpura: This is a rare condition that causes blood vessels to become inflamed, leading to pain, swelling, and bruising in various parts of the body, including the testicles.
    • Polyarteritis nodosa: This is a rare autoimmune disorder that causes blood vessel inflammation, which can lead to testicular pain and other symptoms.
    • Spermatic cord cyst: A spermatic cord cyst is a rare condition where a cyst forms on the spermatic cord, causing pain and swelling in the testicle.

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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