Epididymitis Differential Diagnoses

Updated: Jan 22, 2018
  • Author: Christina B Ching, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Diagnostic Considerations

Epididymitis must be differentiated from testicular torsion, which is a true urologic emergency. Idiopathic scrotal pain and orchialgia can be misdiagnosed as epididymitis. With a proper evaluation and careful physical examination, however, these entities can be distinguished from each other and a proper diagnosis obtained.

Other conditions to consider in the differential diagnosis of epididymitis include the following:

  • Scrotal hernia

  • Inguinal hernia

  • Idiopathic scrotal edema

  • Reactive hydrocele

  • Pyocele

  • Henoch-Schönlein purpura

  • Behçet disease

  • Polyarteritis nodosa

  • Vasculitis

  • Referred or radicular pain

  • Epididymal cyst

  • Epididymal congestion following vasectomy

  • Spermatocele

  • Testicular tumor (hemorrhage into tumor)

  • Tunica vaginalis tumors: Mesothelioma

  • Varicocele

  • Urinary tract infection

Differential Diagnoses