Differential Diagnosis for Testicle Swelling with Mild Pain that Gets Worse when Sitting Down

• Single Most Likely Diagnosis
  • Varicocele: This condition, characterized by an enlargement of the veins within the scrotum, can cause testicle swelling and mild pain that may worsen with sitting due to increased venous pressure.
• Other Likely Diagnoses
  • Epididymitis: Inflammation of the epididymis, often due to infection, can cause testicular pain and swelling. The pain may worsen with activity, including sitting, due to increased movement and pressure on the affected area.
  • Hydrocele: Accumulation of fluid around a testicle can lead to swelling and may cause discomfort, especially when sitting, due to increased pressure on the testicle.
  • Spermatocele: A cystic structure filled with sperm that arises from the head of the epididymis can cause swelling and mild pain, potentially worsening with sitting due to increased pressure.
• Do Not Miss Diagnoses
  • Testicular Torsion: Although typically presenting with severe pain, some cases may have a more gradual onset with mild pain. It's crucial to consider this diagnosis due to the risk of testicular loss if not promptly treated.
  • Testicular Cancer: While less common, testicular cancer can present with a painless testicular mass or swelling. Given the potential severity of this condition, it should always be considered in the differential diagnosis of testicular swelling.
• Rare Diagnoses
  • Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can rarely cause testicular swelling and pain, among other symptoms like purpura and joint pain.
  • Filariasis: In endemic areas, filarial infection can cause lymphatic obstruction leading to hydrocele and, occasionally, testicular swelling and pain.