Major differential diagnosis in a patient who presents with an acutely painful scrotum

In a patient who presents with an acutely painful scrotum, what is the initial diagnostic imaging test of choice, and what is the major differential diagnosis?

In patients with an acutely painful scrotum, US is the initial diagnostic imaging test of choice. Major differential diagnostic considerations include:

  • • Acute epididymo-orchitis.
  • • Spermatic cord torsion.
  • • Torsion of a testicular appendage.
  • • Testicular neoplasm.
  • • Scrotal trauma.
  • • Inguinal hernia.
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