Urgent Care Evaluation of Pain and Swelling in the Scrotum

Points & Pearls Excerpt

• Consider risk factors, and use age and presentation to narrow the differential. Onset, severity, laterality, and associated symptoms can provide important diagnostic clues before physical examination.
• Treat all acute testicular pain as emergent until proven otherwise.
• Consider referred and systemic causes of testicular or scrotal pain. Testicular pathology can present as abdominal pain, while conditions such as immunoglobulin A vasculitis (formerly known as Henoch-Schönlein purpura) and mumps can cause scrotal or epididymal symptoms.
• Testicular salvage after torsion is greatest within the first 6 hours of symptom onset.