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
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.[1][2][3][4]
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:[1][2][3][4]
| 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 |
References
- ↑ 1.0 1.1 Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.
- ↑ 2.0 2.1 Kadish HA, Bolte RG (1998). "A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages". Pediatrics. 102 (1 Pt 1): 73–6. PMID 9651416.
- ↑ 3.0 3.1 Luzzi GA, O'Brien TS (2001). "Acute epididymitis". BJU Int. 87 (8): 747–55. PMID 11350430.
- ↑ 4.0 4.1 Ciftci AO, Senocak ME, Tanyel FC, Büyükpamukçu N (2004). "Clinical predictors for differential diagnosis of acute scrotum". Eur J Pediatr Surg. 14 (5): 333–8. doi:10.1055/s-2004-821210. PMID 15543483.