Testicular Torsion Differential Diagnoses

Updated: Aug 17, 2022
  • Author: Ranjiv I Mathews, MD; Chief Editor: Edward David Kim, MD, FACS  more...
  • Print

Diagnostic Considerations

The constellation of symptoms encompassing the acute scrotum includes new onset pain, tenderness, and swelling. The differential diagnosis of this presentation includes the following [5]

  • Appendage torsion (appendix testis, epididymis, paradidymis, vas aberrans)
  • Spermatic cord torsion – Intravaginal (acute or intermittent) versus extravaginal
  • Epididymitis – Infectious (viral, sexually transmitted infection, urinary tract infection) versus sterile/traumatic
  • Scrotal edema or erythema
  • Orchitis – Associated with epididymitis or abscess, vasculitis, or viral infection (mumps orchitis)
  • Trauma
  • Hernia
  • Hydrocele or intrascrotal mass
  • Varicocele
  • Inguinal tendonitis or muscle strain
  • Referred pain (ureteral calculi)

Differential Diagnoses