Scrotal mass differential diagnosis: Difference between revisions

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Revision as of 19:59, 3 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]

Overview

Scrotal masses may be differentiated according to clinical features, laboratory findings, imaging features, histological features, and genetic studies from other diseases that cause testicular mass with discomfort, back pain, abdominal discomfort, or abdominal mass. Common differential diagnoses include yolk sac tumor, teratoma, choriocarcinoma, embryonal cell carcinoma, seminoma, and testicular lymphoma (usually non-Hodgkin lymphoma).

Differential Diagnosis

The table below summarizes the findings that differentiates scrotal mass according to the clinical features, laboratory findings, imaging features, histological features, and genetic studies.

		Symptoms				Physical examination					Lab Findings		Past Medical History	Histopathology
Scrotal Swelling	Diseases	Clinical manifestations									Para-clinical findings				Gold standard	Associated
Painful		Symptoms				Physical examination					Para-clinical findings
		Unilateral /Bilateral swelling	Onset	Fever	Urinary symptoms	Tenderness	Erythema	Discharge	Inguinal Lymphadenopathy	Cremasteric Reflex	Blood/Urine Analysis	Doppler U/S	Past Medical History	Histopathology
	Epididymitis^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]	Unilateral	Gradual	±	Dysuria, frequency, and/or urgency	+	-	Pyuria Bacteriuria	Painful local lymphadenopathy	+	CBC-Leukocytosis Urine culture (pre-pubertal and elderly) NAAT Immunofluorescent antibody testing	Decreased epididymal blood flow	Enlarged (>17 mm) epididymis with a hypoechoic, hyperechoic, or heterogeneous echotexture, increased blood flow	Acute infection is characterized by infiltration of neutrophils. Chronic cases are characterized by granulomatous inflammation.	Ultrasound for diagnosis (Testicular massesor swollen testicles with hypoechoic and hypervascular areas)	Hydrocele Urinary tract infection Gonococcal infection chlamydia infection Phen sign +ve
	Orchitis (Mumps)^[9]^[10]^[11]^[12] ^[13]^[8]^[7]^[14]	Bilateral	Abrupt	±	Dysuria	+	-	±	Painful local lymphadenopathy	+	CBC-Leukocytosis raised CRP Immunofluorescent antibody testing Urine analysis and culture - normal	Increased blood flow in affected side.	Mumps, coxsackievirus infection Concurrent epididymitis Congenital abnornmalities	Tubules are infiltration with neutrophiles, lymphocytes and cells resembling histiocytes Microscopic destruction of spermatogenic cells	RT‐PCR Serum immunofluorescence antibody testing.	Phen sign +ve Testicular atrophy Infertility
	Testicular Torsion^[15]^[16]^[17]^[18]^[19]^[7]	Unilateral	Sudden	-	-	+	+	Blood in semen may be present	Absent	-	Normal	Absent or decreased arterial perfusion of the testis	Previous history of testicular torsion Family history of testicular torsion Prematurity Undescended testes Low birth weight	In the first 4 hours: testicular parenchyma shows edema and and desquamation of the germ cells 4-8 hours partial necrosis of germ cells. >24 hrs: necrosis	Doppler ultrasound> CT scan	Phen sign +ve
	Hematocele	Unilateral or bilateral	Sudden	-		+	+	Blood in semen	Absent						Ultrasonography: to check for testicular rupture.
	Incarcerated Hernia^[20]^[21]	Unilateral	Sudden	+	Absent	+	+	-	Absent	+	Normal	Normal	-	-	Groin ultrasound or CT scan show presence of bowel and omentum.	Valsalva maneuvers performed while palpating the inguinal canal will push a hernia against the examiner's finger.
	Brucellosis	Unilateral or Bilateral	Sudden	±	Dysuria	-	-	±	Painful local lymphadenopathy	+	CBC-Leukocytosis raised CRP Immunofluorescent antibody testing Urine analysis and culture - normal	Increased blood flow in affected side	-	Acute infection is characterized by infiltration of neutrophils. Chronic cases are characterized by granulomatous inflammation.	Culture of the organism from blood.	Antibodies are detected using: Serum agglutination (standard tube agglutination) Enzyme-linked immunosorbent assay Rose Bengal agglutination Coombs test Immunocapture agglutination (Brucellacapt) 2-mercaptoethanol agglutination
	Torsion of the appendix testis	Unilateral or Bilateral	Sudden	-	Absent	+	-	-	Absent	+	Normal	Normal blood flow to the testis with an occasional increase on the affected side	-	In the first 4 hours: testicular appendages shows edema and and desquamation. 4-8 hours partial necrosis of appendix cells. >24 hrs: necrosis	scrotal ultrasound shows the torsed appendage as a lesion of low echogenicity with a central hypoechogenic area.	Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
	Fournier's gangrene	Bilateral	Sudden	+	-	+	+	-	-	+	Leukocytosis Acidosis Elevated ESR and CRP Blood cultures are positive in majority of patient for streptococcus.	-	-	-	Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.	Patient show signs of tense edema outside the involved skin, blisters, bullae, crepitus, and subcutaneous gas.
Scrotal Swelling	Diseases	Unilateral /Bilateral swelling	Onset	Fever	Urinary symptoms	Tenderness	Erythema	Discharge	Inguinal Lymphadenopathy	Cremasteric Reflex	Blood/Urine Analysis	Doppler U/S	Past Medical History	Histopathology	Gold standard	Additional findings
Painless	Fragile X Macroorchidism	Bilateral	Gradual	-	Absent	--	-	+	Absent	+	Normal	-	-	Increased volume of testis	FMR1 DNA analysis	Long and narrow face with prominent forehead and chin (prognathism) Large ears Intellectual Disability
	Testicular Tumors	Unilateral or bilateral	Gradual	±		±		+
	Henoch-Schonlein purpura					-		-
	Hydrocele^[22]		Gradual	-	Absent	-	-	-	Absent	+					Ultrasound: simple fluid collection	Transillumination test +ve.
	Varicocele^[23]	Unilateral (Mainly left)	Gradual	Local warmth	Absent	-	±	-	Absent	+			Renal cancer Nephrectomy Nut-cracker syndrome		Ultrasonography: tortuous, tubular, anechoic structures adjacent to the testis corresponding to dilated veins of the pampiniform plexus with calibers of 2–3 mm during the Valsalva maneuver
	Spermatocele^[24]		Gradual			-	-	-	Absent	+		Falling snow, resulting from internal echoes moving away from the transducer			Ultrasonography: hypoechoic with posterior acoustic enhancement
	Inguino-scrotal hernia^[25]^[20]					-		-	Absent
	Scrotal edema	Bilateral and can extend to perineum				-	-	-			Eosinophilia					Occurs between 4-12 years of age.
	Epididymal cyst^[26]					±									Ultrasonography: posterior acoustic enhancement, well defined anechoic lesions, larger cysts may contain septations
	Sebaceous cyst
	Carcinoma of the scrotum
	Chylocele (Filariasis)		Gradually/Rapidly
	Cystic dysplasia
	Srotoliths

References

↑ Yu KJ, Wang TM, Chen HW, Wang HH (2012). "The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis". Chang Gung Med J. 35 (1): 38–45. PMID 22483426.
↑ Manavi K, Turner K, Scott GR, Stewart LH (May 2005). "Audit on the management of epididymo-orchitis by the Department of Urology in Edinburgh". Int J STD AIDS. 16 (5): 386–7. doi:10.1258/0956462053888853. PMID 15949072.
↑ Lee YS, Kim SW, Han SW (2018). "Different managements for prepubertal epididymitis based on a preexisting genitourinary anomaly diagnosis". PLoS ONE. 13 (4): e0194761. doi:10.1371/journal.pone.0194761. PMC 5905873. PMID 29668706.
↑ Ralls PW, Jensen MC, Lee KP, Mayekawa DS, Johnson MB, Halls JM (June 1990). "Color Doppler sonography in acute epididymitis and orchitis". J Clin Ultrasound. 18 (5): 383–6. PMID 2161009.
↑ Michel V, Pilatz A, Hedger MP, Meinhardt A (2015). "Epididymitis: revelations at the convergence of clinical and basic sciences". Asian J. Androl. 17 (5): 756–63. doi:10.4103/1008-682X.155770. PMC 4577585. PMID 26112484.
↑ Tracy CR, Costabile RA (April 2009). "The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?". World J Urol. 27 (2): 259–63. doi:10.1007/s00345-008-0338-0. PMID 19002691.
↑ ^7.0 ^7.1 ^7.2 Pepe P, Panella P, Pennisi M, Aragona F (October 2006). "Does color Doppler sonography improve the clinical assessment of patients with acute scrotum?". Eur J Radiol. 60 (1): 120–4. doi:10.1016/j.ejrad.2006.04.016. PMID 16730939.
↑ ^8.0 ^8.1 Ludwig M (April 2008). "Diagnosis and therapy of acute prostatitis, epididymitis and orchitis". Andrologia. 40 (2): 76–80. doi:10.1111/j.1439-0272.2007.00823.x. PMID 18336454.
↑ Davis NF, McGuire BB, Mahon JA, Smyth AE, O'Malley KJ, Fitzpatrick JM (April 2010). "The increasing incidence of mumps orchitis: a comprehensive review". BJU Int. 105 (8): 1060–5. doi:10.1111/j.1464-410X.2009.09148.x. PMID 20070300.
↑ CHARNY CW, MERANZE DR (July 1948). "Pathology of mumps orchitis". J. Urol. 60 (1): 140–6. PMID 18873054.
↑ Bjorvatn B (1973). "Mumps virus recovered from testicles by fine-needle aspiration biopsy in cases of mumps orchitis". Scand. J. Infect. Dis. 5 (1): 3–5. PMID 4580293.
↑ Beard CM, Benson RC, Kelalis PP, Elveback LR, Kurland LT (January 1977). "The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974". Mayo Clin. Proc. 52 (1): 3–7. PMID 609284.
↑ Gall EA (July 1947). "The Histopathology of Acute Mumps Orchitis". Am. J. Pathol. 23 (4): 637–51. PMC 1934294. PMID 19970951.
↑ Başekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF (2000). "Mumps epididymo-orchitis: sonography and color Doppler sonographic findings". Abdom Imaging. 25 (3): 322–5. PMID 10823460.
↑ Hazeltine M, Panza A, Ellsworth P (2017). "Testicular Torsion: Current Evaluation and Management". Urol Nurs. 37 (2): 61–71, 93. PMID 29240370.
↑ Estremadoyro V, Meyrat BJ, Birraux J, Vidal I, Sanchez O (February 2017). "[Diagnosis and management of testicular torsion in children]". Rev Med Suisse (in French). 13 (550): 406–410. PMID 28714632.
↑ Sharp VJ, Kieran K, Arlen AM (December 2013). "Testicular torsion: diagnosis, evaluation, and management". Am Fam Physician. 88 (12): 835–40. PMID 24364548.
↑ Mikuz G (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage". Appl Pathol. 3 (3): 134–9. PMID 3842075.
↑ Gunther P, Schenk JP, Wunsch R, Holland-Cunz S, Kessler U, Troger J, Waag KL (November 2006). "Acute testicular torsion in children: the role of sonography in the diagnostic workup". Eur Radiol. 16 (11): 2527–32. doi:10.1007/s00330-006-0287-1. PMID 16724203.
↑ ^20.0 ^20.1 Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
↑ Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.
↑ Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.
↑ Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid22483426-1] Yu KJ, Wang TM, Chen HW, Wang HH (2012). "The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis". Chang Gung Med J. 35 (1): 38–45. PMID 22483426.

[pmid15949072-2] Manavi K, Turner K, Scott GR, Stewart LH (May 2005). "Audit on the management of epididymo-orchitis by the Department of Urology in Edinburgh". Int J STD AIDS. 16 (5): 386–7. doi:10.1258/0956462053888853. PMID 15949072.

[pmid29668706-3] Lee YS, Kim SW, Han SW (2018). "Different managements for prepubertal epididymitis based on a preexisting genitourinary anomaly diagnosis". PLoS ONE. 13 (4): e0194761. doi:10.1371/journal.pone.0194761. PMC 5905873. PMID 29668706.

[pmid2161009-4] Ralls PW, Jensen MC, Lee KP, Mayekawa DS, Johnson MB, Halls JM (June 1990). "Color Doppler sonography in acute epididymitis and orchitis". J Clin Ultrasound. 18 (5): 383–6. PMID 2161009.

[pmid26112484-5] Michel V, Pilatz A, Hedger MP, Meinhardt A (2015). "Epididymitis: revelations at the convergence of clinical and basic sciences". Asian J. Androl. 17 (5): 756–63. doi:10.4103/1008-682X.155770. PMC 4577585. PMID 26112484.

[pmid19002691-6] Tracy CR, Costabile RA (April 2009). "The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?". World J Urol. 27 (2): 259–63. doi:10.1007/s00345-008-0338-0. PMID 19002691.

[pmid16730939-7] 7.0 ^7.1 ^7.2 Pepe P, Panella P, Pennisi M, Aragona F (October 2006). "Does color Doppler sonography improve the clinical assessment of patients with acute scrotum?". Eur J Radiol. 60 (1): 120–4. doi:10.1016/j.ejrad.2006.04.016. PMID 16730939.

[pmid18336454-8] 8.0 ^8.1 Ludwig M (April 2008). "Diagnosis and therapy of acute prostatitis, epididymitis and orchitis". Andrologia. 40 (2): 76–80. doi:10.1111/j.1439-0272.2007.00823.x. PMID 18336454.

[pmid20070300-9] Davis NF, McGuire BB, Mahon JA, Smyth AE, O'Malley KJ, Fitzpatrick JM (April 2010). "The increasing incidence of mumps orchitis: a comprehensive review". BJU Int. 105 (8): 1060–5. doi:10.1111/j.1464-410X.2009.09148.x. PMID 20070300.

[pmid18873054-10] CHARNY CW, MERANZE DR (July 1948). "Pathology of mumps orchitis". J. Urol. 60 (1): 140–6. PMID 18873054.

[pmid4580293-11] Bjorvatn B (1973). "Mumps virus recovered from testicles by fine-needle aspiration biopsy in cases of mumps orchitis". Scand. J. Infect. Dis. 5 (1): 3–5. PMID 4580293.

[pmid609284-12] Beard CM, Benson RC, Kelalis PP, Elveback LR, Kurland LT (January 1977). "The incidence and outcome of mumps orchitis in Rochester, Minnesota, 1935 to 1974". Mayo Clin. Proc. 52 (1): 3–7. PMID 609284.

[pmid19970951-13] Gall EA (July 1947). "The Histopathology of Acute Mumps Orchitis". Am. J. Pathol. 23 (4): 637–51. PMC 1934294. PMID 19970951.

[pmid10823460-14] Başekim CC, Kizilkaya E, Pekkafali Z, Baykal KV, Karsli AF (2000). "Mumps epididymo-orchitis: sonography and color Doppler sonographic findings". Abdom Imaging. 25 (3): 322–5. PMID 10823460.

[pmid29240370-15] Hazeltine M, Panza A, Ellsworth P (2017). "Testicular Torsion: Current Evaluation and Management". Urol Nurs. 37 (2): 61–71, 93. PMID 29240370.

[pmid28714632-16] Estremadoyro V, Meyrat BJ, Birraux J, Vidal I, Sanchez O (February 2017). "[Diagnosis and management of testicular torsion in children]". Rev Med Suisse (in French). 13 (550): 406–410. PMID 28714632.

[pmid24364548-17] Sharp VJ, Kieran K, Arlen AM (December 2013). "Testicular torsion: diagnosis, evaluation, and management". Am Fam Physician. 88 (12): 835–40. PMID 24364548.

[pmid3842075-18] Mikuz G (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage". Appl Pathol. 3 (3): 134–9. PMID 3842075.

[pmid16724203-19] Gunther P, Schenk JP, Wunsch R, Holland-Cunz S, Kessler U, Troger J, Waag KL (November 2006). "Acute testicular torsion in children: the role of sonography in the diagnostic workup". Eur Radiol. 16 (11): 2527–32. doi:10.1007/s00330-006-0287-1. PMID 16724203.

[pmid18244999-20] 20.0 ^20.1 Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.

[pmid26987468-21] Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.

[pmid174600034-22] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid174600033-23] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid174600032-24] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

[pmid269874682-25] Berger D (2016). "Evidence-Based Hernia Treatment in Adults". Dtsch Arztebl Int. 113 (9): 150–7, quiz 158. doi:10.3238/arztebl.2016.0150. PMC 4802357. PMID 26987468.

[pmid17460003-26] Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H (2007). "Sonographic findings of groin masses". J Ultrasound Med. 26 (5): 605–14. PMID 17460003.

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@@ Line 177: / Line 177: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |±
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |Painful local lymphadenopathy
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>+</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * CBC-[[Leukocytosis]]
 * raised CRP
 * Immunofluorescent antibody testing
 * Urine analysis and culture - normal
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Increased blood flow in affected side
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Increased blood flow in affected side
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * [[Acute]] infection is characterized by infiltration of [[neutrophils]].
 * [[Chronic]] cases are characterized by [[granulomatous]] [[inflammation]].
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Culture of the organism from blood.
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Antibodies are detected using:
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Antibodies are detected using:
 * Serum agglutination (standard tube agglutination)
 * Enzyme-linked immunosorbent assay
@@ Line 199: / Line 199: @@
 |-
 |Torsion of the appendix testis
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Unilateral or Bilateral
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Unilateral or Bilateral
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Sudden
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Absent
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Absent
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Normal
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Normal
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Normal blood flow to the testis with an occasional increase on the affected side
-| style="background: #F5F5F5; padding: 5px; text-align: center;"| -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * In the first 4 hours: testicular appendages shows edema and and desquamation.
 * 4-8 hours partial necrosis of appendix cells.
 * >24 hrs: necrosis
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * scrotal ultrasound shows the torsed appendage as a lesion of low echogenicity with a central hypoechogenic area.
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Scrotal wall mayshow the classical "blue dot" sign, which is due to infarction and necrosis of the appendix testis
 |-
 |[[Fourniers gangrene|Fournier's gangrene]]
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Bilateral
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bilateral
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Sudden
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Sudden
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>+</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>+</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>+</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>+</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Leukocytosis
 * Acidosis
 * Elevated ESR and CRP
 * Blood cultures are positive in majority of patient for streptococcus.
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Computed tomography (CT) scan shows most useful finding is presence of gas in soft tissues.
-| style="background: #F5F5F5; padding: 5px; text-align: center;"|
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |
 * Patient show signs of  tense edema outside the involved skin, blisters, bullae, crepitus, and subcutaneous gas.
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
@@ Line 263: / Line 263: @@
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fragile X syndrome|Fragile X]]   [[Macroorchidism]]
 | style="background: #F5F5F5; padding: 5px;" |Bilateral
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |Gradual
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |-
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |Absent
-| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | --
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |-
 | style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |Absent
+| style="background: #F5F5F5; padding: 5px;" |+
+| style="background: #F5F5F5; padding: 5px;" |Normal
+| style="background: #F5F5F5; padding: 5px;" |-
+| style="background: #F5F5F5; padding: 5px;" |-
+| style="background: #F5F5F5; padding: 5px;" |Increased volume of testis
+| style="background: #F5F5F5; padding: 5px;" |FMR1 DNA analysis
 | style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+* Long and narrow face with prominent forehead and chin (prognathism)
-| style="background: #F5F5F5; padding: 5px;" |
+* Large ears
-| style="background: #F5F5F5; padding: 5px;" |
+* Intellectual Disability
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Testicular Tumors

Scrotal mass differential diagnosis: Difference between revisions

Revision as of 19:59, 3 February 2019

Overview

Differential Diagnosis

References

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