Differential Diagnosis for Hip Pain and Testicular Pain in a 56-year-old Male

Single Most Likely Diagnosis

• Referred pain from a lower back issue: The most common cause of hip pain in older adults is often related to issues with the lower back, such as herniated discs or spinal stenosis. Referred pain can also radiate to the testicles, making this a plausible single diagnosis for both symptoms.

Other Likely Diagnoses

• Prostatitis: Inflammation of the prostate gland can cause pain in the hip area, as well as the testicles, due to the proximity of these organs.
• Kidney stones: While more commonly associated with flank pain, kidney stones can cause radiating pain to the groin and testicles, and sometimes hip pain, especially if the stone is moving.
• Inguinal hernia: An inguinal hernia can cause pain in the groin area that may radiate to the testicles and hip.

Do Not Miss Diagnoses

• Testicular torsion: Although less common in a 56-year-old, testicular torsion is a medical emergency that requires immediate attention. It can cause severe pain and needs to be ruled out.
• Epididymitis or orchitis: Inflammation of the epididymis or testis can cause severe pain and has serious implications if not treated promptly.
• Abdominal aortic aneurysm (AAA): While AAA typically presents with abdominal or back pain, it can sometimes cause radiating pain to the groin or hip area. Given the potential for rupture and high mortality, it's crucial not to miss this diagnosis.

Rare Diagnoses

• Pudendal nerve entrapment: This condition involves the compression of the pudendal nerve and can cause pain in the distribution area of the nerve, including the hip and genital area.
• Sacroiliitis: Inflammation of the sacroiliac joints can cause hip pain and, less commonly, radiating pain to the groin or testicles, especially if there's significant inflammation or if the condition is part of a larger syndrome like ankylosing spondylitis.