Orchitis Differential Diagnoses

Updated: Jan 26, 2023
  • Author: Nataisia Terry, MD; Chief Editor: Erik D Schraga, MD  more...
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Diagnostic Considerations

Testicular torsion is the main differential diagnosis. Patients with testicular torsion typically present with abrupt scrotal pain, whereas those with epididymo-orchitis have a more gradual onset of pain. Testicular torsion is rare in patients older than 35 years. Acute scrotal pain in prepubertal boys occurs most commonly from torsion of the testicular appendages, a process that may clinically mimic testicular torsion or epididymo-orchitis. A pathognomonic physical examination finding (“blue dot sign”) is infrequently encountered. [21]

Differential Diagnoses