Differential Diagnosis for Scrotum 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 one or both testicles, often caused by bacterial or viral infections, which can lead to scrotal pain.
- Testicular torsion (early stages): Although it's a medical emergency, in its early stages, it might not present with the classic severe pain and can be mistaken for other conditions.
- Hydrocele: A condition where fluid accumulates in the scrotum, causing swelling and discomfort, which can sometimes be painful.
- Varicocele: Enlargement of the veins within the scrotum, similar to varicose veins, which can cause aching or discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Testicular torsion (advanced stages): A medical emergency that requires immediate attention. If missed, it can lead to loss of the testicle and potentially long-term fertility issues.
- Testicular cancer: Although less common, it's crucial to consider, especially in men with a history of undescended testes or family history of testicular cancer.
- Fournier's gangrene: A rare but life-threatening condition characterized by necrotizing fasciitis of the genitalia, which can start with scrotal pain and progress rapidly.
- Rare diagnoses
- Spermatocele: A cystic structure filled with sperm that arises from the head of the epididymis, which can cause discomfort or pain.
- Scrotal cellulitis: A bacterial infection of the skin and subcutaneous tissue of the scrotum, which can cause pain, redness, and swelling.
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can affect the scrotum, among other areas, and cause pain and swelling.