Epididymoorchitis differential diagnosis

Epididymoorchitis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Differentiating Epididymoorchitis From Other Diseases

Epididymoorchitis is a major cause of acute scrotum. Other causes of acute scrotum which must be differentiated from epididymoorchitis include testicular torsion and torsion of the testicular appendage:

	Epididymoorchitis	Testicular Torsion	Torsion of the Testicular Appendage
Swelling and redness of the scrotum	can be present	can be present	can be present
Location of pain/tenderness	Testicles and/or epididymis	Testicles	Superior pole of the testis
Onset of pain	Gradual	Sudden	N/A
Urinary symptoms	Can be present	Usually absent	Usually absent
Pain with elevation of the testis	Usually relieved	Usually exacerbated	N/A
Cremasteric Reflex	Usually present	Usually absent	Usually present
"Blue dot" sign	Absent	Absent	Can be present and indicates infarction of the testicular appendage
Testicular lie	Normal	can be high and transverse	Normal
Doppler ultrasound findings	Normal or increased flow	Decreased or absent flow	Normal or increased flow