Differential Diagnosis for 24-year-old with Testicular Pain and Elevated Left Testicle
- Single most likely diagnosis:
- Epididymitis: This condition, characterized by inflammation of the epididymis, is a common cause of testicular pain in young men. The elevated testicle could be due to the body's attempt to reduce pain by retracting the testicle. The pain is often accompanied by swelling, redness, and warmth of the scrotum.
- Other Likely diagnoses:
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections. Symptoms can include testicular pain, swelling, and elevated temperature.
- Testicular torsion (partial): Although testicular torsion typically presents with sudden, severe pain and a high-riding testicle, partial torsion might cause intermittent pain and testicular elevation.
- Hydrocele: A condition where fluid accumulates in the scrotum, causing swelling and potentially mild discomfort. It might not directly cause pain but could lead to a feeling of heaviness or elevation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Testicular torsion: This is a medical emergency that requires immediate attention. The presentation can sometimes be atypical, with less severe pain or gradual onset, but the consequence of missing this diagnosis is testicular loss.
- Testicular cancer: Although less common in this age group, testicular cancer can present with a painless testicular mass or, occasionally, with pain if the tumor causes bleeding or invasion into surrounding structures.
- Rare diagnoses:
- Spermatocele: A cystic structure filled with sperm that arises from the head of the epididymis. It's usually painless but can cause discomfort if large enough.
- Varicocele: Enlargement of the veins within the scrotum, similar to varicose veins. It can cause a feeling of heaviness or aching in the testicle but is typically not associated with an elevated testicle.
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can affect the testicles, causing pain, swelling, and potentially skin purpura. It's more common in children but can occur in young adults.