Differential Diagnosis for a 5-month-old with Elevated and Palpable Testes
Single Most Likely Diagnosis
- Undescended Testes (Cryptorchidism): This condition is common in infants and is characterized by testes that have not moved down into the scrotum. It is a normal variation in some cases but requires monitoring as it can increase the risk of complications such as testicular cancer and infertility if not corrected.
Other Likely Diagnoses
- Retractile Testes: This condition is similar to undescended testes but is more of a physiological response where the testes can move up and down due to an active cremasteric reflex. It's common in young boys and often resolves on its own.
- Ectopic Testes: A condition where the testes are located outside the normal path of descent, often found in the groin or thigh. This is less common than undescended testes but still a consideration in the differential diagnosis.
Do Not Miss Diagnoses
- Testicular Torsion: Although less likely in a 5-month-old without acute symptoms, testicular torsion is a medical emergency that requires immediate attention. It involves the twisting of the spermatic cord, cutting off the blood supply to the testicle.
- Inguinal Hernia: Can sometimes be associated with undescended testes and may present with a bulge in the groin area. While not directly related to the testes' position, it's an important consideration due to potential complications.
Rare Diagnoses
- Testicular Atrophy: Could result from previous testicular torsion or other conditions affecting testicular development. It would be less likely as a primary diagnosis in this scenario without a history of previous issues.
- Intersex Conditions: A group of rare conditions where there's an abnormality in the development of the reproductive organs, which could potentially affect the position and development of the testes. These conditions are rare and would typically be associated with other signs and symptoms.