Differential Diagnosis for Scrotal Pain and Swelling
Single Most Likely Diagnosis
- Epididymitis: This is an inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm. It is often caused by a bacterial infection and is a common cause of scrotal pain and swelling in young men.
Other Likely Diagnoses
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections.
- Testicular torsion: A condition where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It is a medical emergency.
- Hydrocele: A type of swelling in the scrotum that occurs when fluid builds up around a testicle.
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins.
Do Not Miss Diagnoses
- Testicular torsion: Although mentioned earlier, it's crucial to reiterate due to its emergency nature. Delayed treatment can result in loss of the testicle.
- Testicular cancer: Although less common, it can present with pain and swelling. Early detection is key for effective treatment.
- Fournier's gangrene: A rare but serious condition characterized by necrotizing fasciitis of the genitalia, which can be life-threatening if not promptly treated.
Rare Diagnoses
- Spermatocele: A cystic structure that forms on the epididymis and contains sperm.
- Scrotal hematoma: Bleeding into the scrotum, which can be due to trauma or spontaneous.
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can affect the scrotum and cause pain and swelling, though it's more commonly associated with skin, joint, and gastrointestinal symptoms.