A careful history and physical examination are keys to accurately diagnosing the cause of a scrotal swelling and implementing an appropriate course of action.
- The keys to diagnosis of a scrotal swelling are an adequate history and a careful physical examination.
- Swellings in the scrotum are either acute or chronic.
- An acutely swollen painful testis held high with an overlying redness of the scrotum in an older child or adolescent is testicular torsion until proven otherwise.
- Epididymo-orchitis is quite uncommon in children and torsion is less common in adults. If the diagnosis of epididymo-orchitis is uncertain, surgery is indicated to exclude testicular torsion.
- A patient with any mass inside the actual testis requires urgent referral to a urologist because it is a tumour until proven otherwise.