Differential Diagnosis for Testicular Pain in a 9-Year-Old
Single Most Likely Diagnosis
- Epididymitis: This is the most common cause of acute testicular pain in children, often due to a bacterial infection. The age and presentation make this a probable diagnosis.
Other Likely Diagnoses
- Testicular torsion: Although less common than epididymitis, testicular torsion is a significant concern due to the potential for testicular loss if not promptly treated. It typically presents with sudden onset of severe pain.
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, can cause pain and swelling.
- Hydrocele: A collection of fluid around a testicle can cause discomfort or pain, though it's more common in newborns or associated with injury or infection in older children.
Do Not Miss Diagnoses
- Testicular torsion (repeated for emphasis): Due to its urgency and potential for severe consequences if missed, including loss of the testicle.
- Appendicitis: Although abdominal pain is the primary symptom, appendicitis can sometimes refer pain to the testicles, especially if the appendix is located near the testes.
- Kidney stones: While less common in children, kidney stones can cause severe pain that may radiate to the groin or testicles.
Rare Diagnoses
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can cause testicular pain among other symptoms like rash, joint pain, and abdominal pain.
- Mumps orchitis: Now rare due to vaccination, but can cause testicular pain and swelling, usually following parotid gland swelling.
- Testicular cancer: Extremely rare in prepubertal boys, but any persistent testicular mass or pain warrants further investigation.