Differential Diagnosis for Testicular Sensitivity in a 90-year-old Patient
Single most likely diagnosis
- Degenerative changes or age-related testicular atrophy: At 90 years old, degenerative changes are common and can cause testicular sensitivity due to the natural aging process affecting the testicles.
Other Likely diagnoses
- Hydrocele: A common condition in older men where fluid accumulates around a testicle, causing discomfort or sensitivity.
- Epididymitis or orchitis: Although less common in the absence of risk factors for sexually transmitted infections (STIs), these conditions can still occur due to other bacterial sources or non-infectious causes.
- Testicular cysts: Simple cysts of the testdess or epididdess can cause localized sensitivity.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular torsion: Although rare in this age group, testicular torsion is a surgical emergency that can occur at any age and requires immediate attention to save the testicle.
- Testicular cancer: While the peak incidence is in younger men, testicular cancer can occur at any age, and early detection is crucial for treatment outcomes.
- Inguinal hernia: An inguinal hernia can cause testicular discomfort or sensitivity, especially if it becomes incarcerated or strangulated, which is a medical emergency.
Rare diagnoses
- Spermatocele: A cystic mass containing sperm, which can cause localized sensitivity.
- Varicocele: Enlargement of the veins in the scrotum, which can cause discomfort or sensitivity, although it's more commonly associated with infertility issues.
- Testicular infarction: A rare condition where the blood supply to the testicle is compromised, leading to tissue death, which could present with sudden onset of sensitivity and pain.