Differential Diagnosis for Left Testicle Torsion
- Single most likely diagnosis
- Testicular torsion: This is the most likely diagnosis given the presentation of derision (likely referring to severe pain or discomfort) of the left testicle, as testicular torsion is a medical emergency that requires prompt attention. The classic presentation includes sudden onset of severe testicular pain, often accompanied by nausea, vomiting, and abdominal pain.
- Other Likely diagnoses
- Epididymitis: This is an inflammation of the epididymis, usually caused by bacterial infection, and can present with testicular pain and swelling. It's a common cause of acute scrotum and should be considered in the differential diagnosis.
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, can cause pain and swelling similar to testicular torsion.
- Hydrocele: A collection of fluid around a testicle, which can cause swelling and discomfort but typically does not present with the acute pain seen in torsion.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular rupture: Although less common, testicular rupture due to trauma can present with severe pain and must be promptly diagnosed and treated to preserve testicular function.
- Appendicitis (with a retrocecal appendix): In rare cases, appendicitis can present with testicular pain if the appendix is located near the testicles, making it a "do not miss" diagnosis due to the potential for severe complications if not treated promptly.
- Rare diagnoses
- Varicocele: An enlargement of the veins within the scrotum, which can cause a feeling of heaviness or discomfort but is typically not as acute or severe as torsion.
- Spermatocele: A cystic structure filled with sperm, which usually causes a painless lump but can occasionally be painful and might be considered in the differential for chronic or less severe presentations.
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can cause testicular pain among other symptoms, though it is rare and more commonly associated with skin, joint, and gastrointestinal manifestations.