CLINICAL DIAGNOSTIC MANUAL
Scrotal inflammation is a clinical finding that can result from various conditions affecting the scrotum and its contents, including the testes, epididymis, and surrounding tissues.
Scrotal inflammation can present with pain, swelling, redness, and warmth, and it may be associated with systemic symptoms such as fever. Identifying the underlying cause is crucial for guiding appropriate treatment and preventing complications, such as infertility or abscess formation.
Pathology | Symptoms and Clinical Signs | Suspicion Diagnosis | Confirmatory Diagnosis |
Epididymitis | Scrotal pain and swelling, tenderness, fever, dysuria, pain radiating to the groin | Clinical history, physical examination | Scrotal ultrasound, urinalysis, urine culture |
Orchitis | Scrotal pain, swelling, and tenderness, fever, nausea, vomiting, unilateral or bilateral involvement | Clinical history, physical examination | Scrotal ultrasound, blood tests (CRP, ESR), viral serology (mumps) |
Testicular Torsion | Sudden onset of severe scrotal pain, swelling, nausea, vomiting, absence of cremasteric reflex | Clinical history, physical examination | Scrotal ultrasound with Doppler, urgent surgical exploration |
Hydrocele | Painless scrotal swelling, transillumination of the scrotum, heaviness | Clinical history, physical examination | Scrotal ultrasound |
Inguinal Hernia | Scrotal swelling, pain, bulging in the inguinal area, reducible or irreducible hernia | Clinical history, physical examination | Scrotal and inguinal ultrasound, abdominal CT scan |
Varicocele | Dull, aching scrotal pain, swelling, “bag of worms” sensation on palpation, typically on the left side | Clinical history, physical examination | Scrotal ultrasound with Doppler |
Testicular Tumor | Painless scrotal mass, heaviness, possible dull ache, swelling | Clinical history, physical examination | Scrotal ultrasound, tumor markers (AFP, hCG), CT scan for staging |
Scrotal Abscess | Painful scrotal swelling, redness, warmth, fever, fluctuance | Clinical history, physical examination | Scrotal ultrasound, aspiration or drainage for culture |
Fournier’s Gangrene | Severe scrotal pain, swelling, redness, rapid progression, systemic symptoms (fever, sepsis) | Clinical history, physical examination | Scrotal ultrasound, CT scan, immediate surgical exploration and debridement |
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