What are the causes of testicular pain (orchialgia)?

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Differential Diagnosis for Testicular Pain

  • Single most likely diagnosis
    • Epididymitis: This is the most common cause of testicular pain, 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.
    • Testicular torsion (partial): A condition where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It can cause severe pain, but may not always present with the classic signs of torsion.
    • Varicocele: An enlargement of the veins within the scrotum, which can cause a dull ache or discomfort.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular torsion (complete): A medical emergency that requires immediate attention. If left untreated, it can lead to loss of the testicle and potentially life-threatening complications.
    • Testicular cancer: Although rare, testicular cancer can cause pain, and early detection is crucial for effective treatment.
    • Appendicitis (with referred pain): In some cases, appendicitis can cause referred pain to the testicles, and missing this diagnosis can lead to severe consequences.
  • Rare diagnoses
    • Henoch-Schönlein purpura: A rare condition that can cause testicular pain, swelling, and bruising.
    • Polyarteritis nodosa: A rare autoimmune disorder that can cause testicular pain and swelling.
    • Spermatic cord cyst: A rare condition where a cyst forms on the spermatic cord, causing pain and swelling.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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