Epididymoorchitis differential diagnosis
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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]
Overview
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 |