Differential Diagnosis for Scrotal Pain
- Single most likely diagnosis
- Epididymitis: This is the most common cause of scrotal pain, especially in young men. It is usually caused by a bacterial infection and presents with pain, swelling, and tenderness of the epididymis.
- Other Likely diagnoses
- Orchitis: Inflammation of the testicle, often caused by viral or bacterial infections, can cause scrotal pain and swelling.
- Testicular torsion (partial): While not as common as epididymitis, partial testicular torsion can cause intermittent scrotal pain and should be considered in the differential diagnosis.
- Varicocele: Enlargement of the veins in the scrotum can cause a dull, aching pain, especially when standing or exerting oneself.
- Hydrocele: Accumulation of fluid around the testicle can cause scrotal swelling and discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Testicular torsion (complete): A medical emergency that requires immediate attention, complete testicular torsion can cause severe, sudden scrotal pain and swelling.
- Testicular cancer: Although rare, testicular cancer can cause scrotal pain, swelling, or a palpable mass, and early detection is crucial for treatment.
- Fournier's gangrene: A rare but life-threatening condition caused by a bacterial infection of the skin and soft tissues of the genital area, which can cause severe scrotal pain, swelling, and necrosis.
- Rare diagnoses
- Spermatocele: A cystic structure filled with sperm, which can cause scrotal pain and swelling.
- Scrotal hematoma: Bleeding into the scrotum can cause pain, swelling, and bruising.
- Henoch-Schönlein purpura: A rare autoimmune disorder that can cause scrotal pain, swelling, and purpura (bleeding under the skin).