Differential Diagnosis for Scrotal Pain

The patient presents with scrotal pain, burning with urination, and discomfort in the right testicle. The following differential diagnoses are considered:

• Single most likely diagnosis
  • Epididymitis: This is the most likely diagnosis given the patient's symptoms of scrotal pain, burning with urination, and tenderness over the right testicle. Epididymitis is an inflammation of the epididymis, often caused by bacterial infection, which is consistent with the patient's symptoms of burning with urination and testicular pain.
• Other Likely diagnoses
  • Orchitis: This is an inflammation of one or both testicles, often caused by bacterial or viral infection. The patient's symptoms of testicular pain and swelling are consistent with orchitis.
  • Urethritis: This is an inflammation of the urethra, often caused by bacterial infection. The patient's symptoms of burning with urination are consistent with urethritis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular Torsion: This is a medical emergency that requires prompt attention. Although the patient denies any trauma or falls, testicular torsion can occur spontaneously. The patient's symptoms of sudden onset of testicular pain and swelling are consistent with testicular torsion.
  • Appendicitis (with a retrocecal appendix): Although less common, appendicitis can present with testicular pain and swelling if the appendix is located in a retrocecal position.
• Rare diagnoses
  • Henoch-Schönlein Purpura (HSP): This is a rare condition that can cause testicular pain and swelling, but it is often associated with other symptoms such as purpura, arthritis, and abdominal pain.
  • Sarcoidosis: This is a rare condition that can cause testicular pain and swelling, but it is often associated with other symptoms such as lung disease and skin lesions.