Differential Diagnosis for Left Testicular Pain

• Single most likely diagnosis
  • Musculoskeletal pain: This is often the most common cause of testicular pain, given the high prevalence of musculoskeletal issues and the fact that testicular pain can sometimes be referred from surrounding structures.
• Other Likely diagnoses
  • Left varicocele: As mentioned, varicoceles are a common cause of testicular pain, especially if they are large or have developed recently. The pain is usually dull and aching.
  • Epididymitis: Inflammation of the epididymis, which can be caused by infection, can lead to testicular pain. It's more common in sexually active men but can also occur in other contexts.
  • Testicular torsion (early stages): While this is more of an emergency, early stages might present with less severe pain, making it a consideration in the differential diagnosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular torsion: This is a surgical emergency. If missed, it can lead to loss of the testicle and potentially long-term fertility issues.
  • Testicular cancer: While less common, testicular cancer can present with pain, and missing this diagnosis could have significant implications for treatment and prognosis.
  • Acute epididymo-orchitis: Severe infection involving both the epididymis and testis, which can lead to serious complications if not promptly treated.
• Rare diagnoses
  • Henoch-Schönlein purpura (HSP): A systemic vasculitis that can cause testicular pain among other symptoms.
  • Polyarteritis nodosa (PAN): A vasculitis affecting medium-sized arteries, which can rarely cause testicular pain.
  • Spermatocele or epididymal cyst: These are usually painless but can occasionally cause discomfort or pain if they become large or inflamed.