Differential Diagnosis for Painful Testicles
- Single most likely diagnosis
- Epididymitis: This is the most common cause of painful testicles, especially in young men. It is usually caused by a bacterial infection, and 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 a viral or bacterial infection. It can cause severe pain, swelling, and tenderness of the testicles.
- Testicular torsion (partial): While not as common as epididymitis, partial testicular torsion can cause intermittent pain and may not always present with the classic signs of testicular torsion.
- Varicocele: Enlargement of the veins within the scrotum, which can cause a dull, aching pain, especially after standing for long periods.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Testicular torsion: A medical emergency that requires immediate attention. It occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle. If not treated promptly, it can lead to loss of the testicle.
- Testicular cancer: Although rare, testicular cancer can cause pain, especially if the tumor is large or has spread. It is essential to rule out cancer in any case of testicular pain.
- Rare diagnoses
- Henoch-Schönlein purpura (HSP): A rare condition that can cause testicular pain, swelling, and bruising, often accompanied by abdominal pain, joint pain, and a characteristic rash.
- Polyarteritis nodosa (PAN): A rare autoimmune disorder that can cause testicular pain, swelling, and inflammation, often accompanied by systemic symptoms such as fever, weight loss, and fatigue.
- Spermatocele: A rare condition where a cyst forms in the epididymis, which can cause pain, swelling, and discomfort in the testicle.