Differential Diagnosis for Intermittent Testicle Pain with Intermittent Elevation of Scrotum
- The following differential diagnosis is organized into categories to guide the diagnostic process.
Single Most Likely Diagnosis
- Torsion of the testicular appendages (e.g., appendix testis): This condition is a common cause of intermittent testicular pain, especially in children and young adults. The appendix testis is a small, vestigial structure attached to the testis that can twist and cause pain.
Other Likely Diagnoses
- Varicocele: A varicocele is an enlargement of the veins in the scrotum, which can cause intermittent pain and elevation of the scrotum. It is more common on the left side.
- Hydrocele: A hydrocele is an accumulation of fluid around the testis, which can cause intermittent pain and elevation of the scrotum.
- Epididymitis: Inflammation of the epididymus, a tube behind the testis that stores sperm, can cause intermittent pain and elevation of the scrotum.
- Testicular torsion (intermittent): Although less common, intermittent testicular torsion can occur, where the testis twists and then untwists, causing intermittent pain.
Do Not Miss Diagnoses
- Testicular cancer: Although rare, testicular cancer can present with intermittent pain and elevation of the scrotum. It is essential to rule out this diagnosis to avoid delayed treatment.
- Acute testicular torsion: This is a surgical emergency that requires prompt attention. Although the question mentions intermittent pain, it is crucial to consider acute torsion in the differential diagnosis.
- Inguinal hernia: An inguinal hernia can cause intermittent pain and elevation of the scrotum, especially if the hernia is incarcerated or strangulated.
Rare Diagnoses
- Spermatocele: A spermatocele is a cystic structure filled with sperm, which can cause intermittent pain and elevation of the scrotum.
- Cyst of the ductus deferens: A cyst of the ductus deferens is a rare condition that can cause intermittent pain and elevation of the scrotum.
- Neurogenic causes (e.g., nerve entrapment): Rarely, intermittent testicular pain can be caused by nerve entrapment or other neurogenic conditions.