What is the differential diagnosis (DDX) for testicular pain?

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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 sexually active young men. It is usually caused by a bacterial infection, such as Chlamydia or Gonorrhea.
  • Other Likely diagnoses
    • Orchitis: Inflammation of the testis, often caused by viral infections such as mumps or bacterial 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, which can cause a dull ache or discomfort.
    • Hydrocele: Accumulation of fluid around a testicle, leading to swelling and discomfort.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Testicular torsion (advanced stages): A medical emergency that requires immediate attention. Delayed treatment can result in loss of the testicle.
    • Testicular cancer: Although rare, it's crucial to rule out, especially in men with a history of undescended testes or family history of testicular cancer.
    • Appendicitis (with referred pain): In some cases, appendicitis can cause referred pain to the testicles, especially if the appendix is located near the testes.
  • Rare diagnoses
    • Henoch-Schönlein purpura: A form of vasculitis that can cause testicular pain, usually accompanied by other symptoms like rash and joint pain.
    • Polyarteritis nodosa: A rare autoimmune disease that can cause testicular pain due to inflammation of the blood vessels.
    • Spermatocele: A cystic structure filled with sperm, which can cause discomfort or pain, although it's usually asymptomatic.

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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