Differential Diagnosis for Testicular Pain and Swelling in a 16-Year-Old Male
Single Most Likely Diagnosis
- Epididymitis: This is the most common cause of testicular pain and swelling in adolescents, often resulting from a bacterial infection, typically Chlamydia or Gonorrhea. The age and symptoms align with this diagnosis.
Other Likely Diagnoses
- Testicular torsion: Although less common, it's a significant consideration due to the potential for severe consequences if not promptly treated. It occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle.
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections. It can occur alone or in conjunction with epididymitis.
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins. While often asymptomatic, it can cause discomfort and swelling.
Do Not Miss Diagnoses
- Testicular torsion (repeated for emphasis): Due to its potential for severe and irreversible damage if not treated promptly, it's crucial to rule out testicular torsion immediately.
- Testicular cancer: Although rare in this age group, any testicular mass or swelling warrants consideration of testicular cancer to ensure early detection and treatment.
- Appendicitis (with an atypical presentation): In rare cases, appendicitis can present with testicular pain due to the appendix being located near the testicles, especially if the appendix is retrocecal.
Rare Diagnoses
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can cause testicular pain and swelling, among other symptoms like purpura, joint pain, and gastrointestinal issues.
- Spermatocele or hydrocele: Accumulations of fluid in the scrotum that can cause swelling but are less commonly associated with significant pain.
- Trauma: Direct injury to the testicles can cause pain and swelling but would typically be associated with a clear history of trauma.