January Week 3: Testicular Pain/Swelling & Undescended Testes

Articles

• Gatti J, at al. Acute Testicular Disorders. Peds in Review. 2008:29;265-241.
• Callaghan P. Undescended Testis. Peds in Review. 2000;21;395

Case 1

A 15 year old boy comes to see you for a sick visit accompanied by mom complaining of abdominal pain. When mom leaves the room for the exam, your patient admits the real reason for coming is for right sided scrotal pain that has been worsening over the last 3 days. He is sexually active.

What else will you ask him
What important exam findings will you look for on exam? 
What is your differential diagnosis? What is your most likely diagnosis? 
What is your next step?

Case 2

A 15 year old boy comes to see you for a sick visit after developing severe acute right scrotal pain at school today. He is sexually active.

What else will you ask him? 
What important exam findings will you look for on exam? 
What is your differential diagnosis? What is your most likely diagnosis?
What is your next step?

Case 3

You are examining a 2 month old boy who is a new patient to your practice. On exam, you note that the right testicle is not located in the scrotum, but you are able to locate it along the inguinal canal and manually bring it down into the scrotum. The parents ask you about the significance of this finding.

What important findings will you look for on exam? 
What do you tell the parents? What is your next step?