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
  • Orchitis: Inflammation of one or both testicles, usually caused by a viral or bacterial infection. It can cause severe pain, swelling, and redness of the testicle.
  • Testicular torsion (early stages): Although it's a medical emergency, in its early stages, testicular torsion might not present with the classic severe pain and might be mistaken for other conditions.
  • Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins. It can cause a dull ache or discomfort in the testicle.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular torsion: A medical emergency that requires immediate attention. It occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle. Delayed treatment can result in loss of the testicle.
  • Testicular cancer: Although rare, testicular cancer can present with pain, and it's crucial to rule it out, especially in younger men.
  • Appendicitis (with referred pain): In some cases, appendicitis can cause referred pain to the testicle, especially if the appendix is located near the testicle.
• Rare diagnoses
  • Henoch-Schönlein purpura: 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: A rare autoimmune disorder that causes blood vessel inflammation, which can lead to testicular pain.
  • Spermatic cord cyst: A rare condition where a cyst forms on the spermatic cord, causing pain and swelling.