Epididymitis: Although the patient denies dysuria, epididymitis can occur without urinary symptoms, especially in older adults. The presence of hyaline and granular casts in the urine may indicate a urinary tract issue that could be related to or exacerbate epididymitis.

Orchitis: Inflammation of one or both testicles, which could be due to viral or bacterial infection. The absence of dysuria does not rule out orchitis, as it can be caused by non-sexually transmitted infections.
Testicular Torsion: Although less common in older adults, testicular torsion is a possibility, especially if the patient has a history of testicular abnormalities. It is characterized by severe pain and requires immediate medical attention.
Prostatitis: Given the patient's age and the presence of urinary casts, prostatitis (inflammation of the prostate) could be a contributing factor to testicular pain, especially if the prostate is enlarged or infected.

Testicular Cancer: While less likely to present with acute pain, testicular cancer can cause discomfort or pain and is crucial not to miss due to its potential for cure with early detection.
Aortic Aneurysm or Aortic Dissection: These conditions can refer pain to the testicles and are life-threatening. Although the patient denies flank pain, the possibility of an aortic issue should be considered, especially in an older adult.
Renal Infarction: Could potentially cause referred pain to the testicles and is a serious condition that requires prompt diagnosis and treatment.

Henoch-Schönlein Purpura (HSP): A form of vasculitis that can cause testicular pain among other symptoms. It's more common in children but can occur in adults.
Polyarteritis Nodosa (PAN): A systemic vasculitis that can affect various parts of the body, including the testicles, causing pain.
Spermatic Cord Torsion: A rare condition where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It's more common in younger men but can occur at any age.