Version June 2024
This algorithm summarizes our suggested approach to evaluating acute scrotal pain. Diagnostic ultrasound is indicated in most patients; the exceptions include situations where imaging may delay urgent intervention (eg, Fournier's gangrene) or in classic cases of nonsurgical diagnoses (eg, epididymitis, torsion of the appendix testis) as diagnosed by an experienced clinician. In all other instances, the combination of clinical features and ultrasound findings inform the diagnostic evaluation, especially in situations where ultrasound results are equivocal.
This algorithm is intended for use in conjunction with additional UpToDate content. For additional details, refer to UpToDate topics on acute scrotal pain in adults.* Other diagnoses that may present with acute scrotal pain include trauma, postvasectomy pain, testicular cancer, immunoglobulin A (IgA) vasculitis (Henoch-Schönlein purpura), acute idiopathic scrotal edema, resolved or intermittent testicular torsion, and referred pain (diagnosis of exclusion).
¶ Torsion of the appendix testis is rare in adults. When it occurs, pain localizes to the anterosuperior pole of the testis. A "blue dot" sign on examination is a late finding that, when present, is highly suggestive of appendix testis torsion.
Δ An intact cremasteric reflex is most often seen in boys between 30 months and 12 years of age and is less consistent in older males. Thus, the absence of a cremasteric reflex does not necessarily indicate testicular torsion.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
