Differential Diagnosis for Abdominal Pain Radiating to the Testicles
- Single Most Likely Diagnosis
- Kidney stones (nephrolithiasis): This condition often presents with severe abdominal pain that radiates to the groin or testicles, especially if the stone is moving down the ureter. The pain is typically colicky in nature, meaning it comes and goes in waves.
- Other Likely Diagnoses
- Epididymitis: Inflammation of the epididymis, usually due to infection, can cause pain in the testicle that may radiate from the abdomen.
- Orchitis: Inflammation of one or both testicles, often due to bacterial or viral infection, can cause testicular pain that may be referred from the abdomen.
- Inguinal hernia: Especially if the hernia is incarcerated or strangulated, it can cause severe pain that radiates to the testicles.
- Do Not Miss Diagnoses
- Testicular torsion: A medical emergency where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It presents with sudden, severe testicular pain that may radiate from the abdomen and is often accompanied by nausea and vomiting.
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, in some cases, especially if the appendix is retrocecal, the pain can radiate to the testicles.
- Aortic dissection or abdominal aortic aneurysm: These are life-threatening conditions that can cause severe abdominal pain radiating to the back or groin, including the testicles, due to the proximity of these structures to the aorta.
- Rare Diagnoses
- Varicocele: An enlargement of the veins within the scrotum, which can cause a dull ache in the testicle that may be referred from the abdomen, though this is less common.
- Henoch-Schönlein purpura: A form of vasculitis that can cause abdominal pain and testicular pain among other symptoms, though it is more commonly associated with skin rash and joint pain.
- Pudendal neuralgia: A condition characterized by pain in the distribution of the pudendal nerve, which can include the testicles, but this is a less common cause of abdominal pain radiating to the testicles.