Differential Diagnosis for Right Testicular Pain

• Single most likely diagnosis
  • Epididymitis: This is the most common cause of acute testicular pain, often resulting from bacterial infection, typically affecting young men.
• Other Likely diagnoses
  • Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections.
  • Testicular torsion (early stages): Although it's a medical emergency, in its early stages, it might not present with the classic severe pain and can be mistaken for other conditions.
  • Varicocele: Enlargement of the veins within the scrotum, similar to varicose veins, which can cause aching or discomfort.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular torsion: A surgical emergency that requires immediate attention to save the affected testicle and preserve fertility.
  • Testicular cancer: Although less common, it's crucial to rule out, especially in men with a history of undescended testes or family history of testicular cancer.
  • Appendicitis (with an atypical presentation): Rarely, appendicitis can present with testicular pain if the appendix is located near the testicles.
• Rare diagnoses
  • Henoch-Schönlein purpura: A form of vasculitis that can cause testicular pain among other symptoms like rash and joint pain.
  • Polyarteritis nodosa: A systemic vasculitis that can affect various organs, including the testicles, causing pain.
  • Spermatocele or epididymal cyst: Benign cysts that can cause discomfort or pain, especially if they become large or infected.