Differential Diagnosis for Tender Lump in Left Inguinal Crease

Single Most Likely Diagnosis

• Inguinal Hernia: This is the most common cause of a lump in the inguinal region. The tenderness could be due to an incarcerated or strangulated hernia, which are complications that require urgent medical attention.

Other Likely Diagnoses

• Lymphadenitis: Inflammation of the lymph nodes in the inguinal region can cause tender lumps. This could be due to a bacterial or viral infection.
• Folliculitis or Abscess: An infection of the hair follicles or a collection of pus in the skin can cause a tender lump in the inguinal crease.
• Hydrocele: Although typically painless, an infected hydrocele or one that has become inflamed could present as a tender lump.
• Varicocele: While usually asymptomatic and found on the left side, a varicocele can occasionally become tender if thrombosed or inflamed.

Do Not Miss Diagnoses

• Testicular Torsion: Although the lump is in the inguinal crease, testicular torsion is an emergency that can sometimes present with a swollen, tender mass in the groin area if the testis has retracted upwards.
• Strangulated Hernia: A hernia that has become strangulated (cut off from its blood supply) is a surgical emergency and can present with severe pain and tenderness.
• Epididymo-orchitis: Inflammation of the epididymis and testis can cause severe pain and swelling that might be referred to the inguinal area.

Rare Diagnoses

• Lipoma: A benign tumor of fat cells can occur anywhere, including the inguinal region, but is less likely to be tender unless it becomes inflamed or infected.
• Sarcoma: A rare type of cancer that can occur in soft tissues, including the inguinal region, but would be unusual as a primary presentation with a tender lump.
• Psoas Abscess: An abscess in the psoas muscle can cause a tender mass in the groin area, although this is relatively rare and usually associated with significant systemic symptoms.