II. Causes: Groin Swelling
- Undescended Testicle (Cryptorchidism)
- Inguinal Lymphadenopathy (or Lymphadenitis, e.g. Chlamydia, Lymphogranuloma venereum)
- Femoral arterial aneurysm or pseudoaneurysm
- Inguinal Hernia
- Femoral Hernia
- Hematoma
- Hidradenitis Suppurativa
- Lipoma
- Lymphoma
- Metastatic cancer
- Psoas abscess
- Sebaceous Cyst
III. Causes: Generalized Edema
- Lymphedema
- Fournier's Gangrene
-
Anasarca
- Congestive Heart Failure
- Renal Failure
- Hepatic Failure with Ascites
IV. Causes: Skin Lesions
V. Causes: Scrotal, Testicular or Epididymis Swelling
- See Scrotal Pain
- Acute and Tender
- Testicular Torsion
- Acute unilateral Scrotal Swelling and Scrotal Pain
- Pain not relieved with Prehn's Sign (unreliable)
- Associated with a high riding Testicle and Nausea or Vomiting
- Torsion of Testicular Appendage
- Orchitis or Epididymitis
- Acute unilateral Scrotal Swelling and pain adjacent to Testicle and may be relieved with Prehn's Sign
- May be associated with Dysuria, fever, scrotal erythema
- Increased C-Reactive Protein (CRP) >24 mg/ml in most cases
- Testicular Torsion
- Chronic and Non-tender
- Varicocele
- Soft lumps superior to the Testicle (bag of worms), esp. in left Scrotum
- Dull ache or heaviness Sensation may be present, worse with standing or Valsalva Maneuver
- Testicular carcinoma
- Firm, unilateral Nodule (may present with pain in some cases)
- Hydrocele
- Hematocele
- Spermatocele
- Inguinal Hernia
- Soft mass in the Scrotum or Inguinal Canal
- Indirect Inguinal Hernia often palpable with Valsalva Maneuver
- Epidermoid Cyst
- Varicocele
VI. Causes: Spermatic cord swelling
-
Indirect Inguinal Hernia
- Typically unilateral bulging of Scrotum provoked with Valsalva Maneuver
-
Varicocele
- Dull ache-type Scrotal Pain provoked with standing
- "Bag of worms" like swelling
-
Hydrocele
- Fluid collection around the Testicle that transilluminates
VII. History
- Is pain present?
- Timing (acute or chronic)?
- Exacerbating and palliative factors?
- Associated constitutional symptoms (e.g. fever, chills, Night Sweats, weight loss)?
- Abdominal Pain?
- Dysuria?
- Hematuria?
VIII. Exam
- Palpate Testicle and spermatic cord for Nodules or masses
- Cremasteric Reflex
- Prehn Sign
- Inguinal Canal palpation with Valsalva Maneuver
- Transillumination of the Scrotum (Hydrocele allows light transmission)
IX. Imaging: Scrotal Ultrasound with Doppler Imaging
- Scrotal Ultrasound is indicated in most cases of Scrotal Mass
- Testicular Torsion is an emergency and requires immediate evaluation
X. References
- Cristoforo (2019) Crit Dec Emerg Med 33(10): 15-20
- Butani (2022) Am Fam Physician 106(5): 571-2 [PubMed]
- Langan (2022) Am Fam Physician 106(2): 184-9 [PubMed]
- LeBlanc (2013) Am Fam Physician 87(12): 844-8 [PubMed]
- Crawford (2014) Am Fam Physician 89(9): 723-7 [PubMed]
- Thomas (2022) Am Fam Physician 105(1): 77-8 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
Concepts | Finding (T033) |
SnomedCT | 53929009 |
Italian | Massa dello scroto |
Japanese | 陰嚢腫瘤, インノウシュリュウ |
English | scrotal lump (symptom), scrotum mass, mass in scrotum, scrotal lump, scrotal mass (physical finding), scrotal mass, lump in the scrotum, Scrotal mass (disorder), Mass of scrotum, Mass of scrotum (finding), mass scrotum, masses scrotum, masses scrotal, Scrotal mass, Scrotal mass, NOS |
Czech | Útvar ve skrotu |
Spanish | masa escrotal (trastorno), tumor escrotal, masa escrotal, masa escrotal (hallazgo), masa de escroto (hallazgo), bulto escrotal, masa de escroto, Masa escrotal |
Hungarian | Scrotalis térfoglaló folyamat |
Portuguese | Massa escrotal |
Dutch | scrotumgezwel |
French | Masse scrotale |
German | Raumforderung Skrotum |
Ontology: Edema of scrotum (C0151609)
Concepts | Finding (T033) |
SnomedCT | 88995000 |
English | EDEMA SCROTUM, OEDEMA SCROTUM, Scrotum Edema, scrotum edema, scrotal edema, scrotal edema (physical finding), Edema scrotal, Edema scrotum, Oedema scrotal, Oedema scrotum, Scrotal edema, Scrotal oedema, Edema of scrotum, Oedema of scrotum, Edema of scrotum (disorder), edema; scrotum, scrotum; edema |
Italian | Edema dello scroto |
Dutch | scrotum oedeem, scrotaal oedeem, oedeem scrotum, oedeem scrotaal, oedeem; scrotum, scrotum; oedeem, scrotaaloedeem |
French | Oedème scrotal, OEDEME DU SCROTUM, Oedème du scrotum |
German | Oedem des Skrotums, OEDEM SKROTUM, Skrotumoedem |
Spanish | Edema de escroto, edema del escroto (trastorno), edema del escroto, edema escrotal, Edema escrotal |
Japanese | 陰嚢浮腫, インノウフシュ |
Portuguese | EDEMA DO ESCROTO, Edema do escroto |
Czech | Edém šourku, Skrotální edém, Edém skrota |
Hungarian | Scrotum vizenyő, Scrotalis oedema, scrotalis oedema, Herezacskó oedema, Scrotalis vizenyő, Scrotum oedema |
Ontology: Inguinal mass (C0240007)
Concepts | Sign or Symptom (T184) |
SnomedCT | 207249001, 207248009, 281398003, 274742009 |
Italian | Massa inguinale |
English | [D]Groin lump (context-dependent category), [D]Groin mass (context-dependent category), [D]Groin lump, [D]Groin mass, groin lump, inguinal mass, lump groin, groin mass, groin lumps, Mass of inguinal region, [D]Groin mass (situation), [D]Groin lump (situation), Inguinal mass, Groin lump, Groin mass, Groin mass (finding), Groin lump (finding), Inguinal Mass, lump in the groin, Lump(s);groin |
Japanese | 鼡径部腫瘤, ソケイブシュリュウ |
Spanish | [D]bulto en la ingle (categoría dependiente del contexto), [D]masa en la ingle (categoría dependiente del contexto), bulto de la región inguinal, bulto de la región inguinal (hallazgo), tumoración de la región inguinal, tumoración de la región inguinal (hallazgo), masa inguinal, masa en la ingle (hallazgo), [D]masa en la ingle (situación), [D]bulto en la ingle (situación), [D]masa inguinal, [D]tumoración inguinal, [D]bulto inguinal, [D]bulto en la ingle, masa en la ingle, [D]tumoración en la ingle, [D]masa en la ingle, Masa inguinal |
Czech | Rezistence v třísle |
Hungarian | Inguinalis térfoglaló folyamat |
Portuguese | Massa inguinal |
Dutch | liesgezwel |
French | Masse inguinale |
German | Raumforderung in der Inguinalgegend |
Ontology: Testicular mass (C0241353)
Concepts | Finding (T033) |
SnomedCT | 87860000, 276377005, 140593003, 309533009, 163384008 |
English | TESTES MASS, TESTIS MASS, Testicular Mass, testicular lump, testes mass, testicular mass, testicular mass (physical finding), lump in the testis, testicular lump (symptom), Testicular mass, Mass of testicle (finding), Testicular mass (disorder), Mass of testicle, lump in testis, masses testicular, lump testes, lumps testes, masses testicle, swollen teste, testis mass, lumps testicular, swollen testes, Lump(s);testes, swelling testicles, swelling testicle, lumps testis, swollen testis, testicle swelling, lump testicular, mass testicular, swelling of testicles, testicle mass, testicular swelling, Testicular lump (finding), Mass of testis (finding), Testicular mass (finding), Testicular lump, Lump in testis, Mass of testis, Testicular lump, NOS, Testicular mass, NOS |
Italian | Massa del testicolo |
Japanese | 精巣腫瘤, セイソウシュリュウ |
Czech | Útvar v oblasti varlete |
Spanish | masa testicular (trastorno), masa testicular (hallazgo), bulto testicular, masa testicular, Masa testicular |
Hungarian | Testicularis térfoglaló folyamat |
Portuguese | Massa testicular |
Dutch | testikelgezwel |
French | Masse testiculaire |
German | testikulaere Masse |
Ontology: Swelling of scrotum (C0282005)
Concepts | Sign or Symptom (T184) |
SnomedCT | 207202000, 271687003 |
Italian | Rigonfiamento dello scroto |
English | [D]Swelling of scrotum (context-dependent category), [D]Swelling of scrotum, scrotal swelling, scrotal swelling (symptom), Scrotum swelling, Swollen;scrotum, scrotum swell, scrotum swollen, swollen scrotum, scrotum swelling, scrotal swellings, [D]Swelling of scrotum (situation), Scrotal swelling, Swelling of scrotum, Swollen scrotum, Swelling of scrotum (finding), scrotum; swelling, swelling; scrotum |
Dutch | zwelling scrotum, scrotum; zwelling, zwelling; scrotum, balzakzwelling |
Spanish | Hinchazón del escroto, [D]tumefacción del escroto (categoría dependiente del contexto), [D]tumefacción escrotal, [D]tumefacción del escroto, [D]tumefacción del escroto (situación), tumefacción del escroto (hallazgo), tumefacción del escroto, Hinchazón escrotal |
Japanese | 陰嚢腫脹, インノウシュチョウ |
Czech | Otok skrota, Otok šourku |
Hungarian | Scrotum duzzanat, Scrotalis duzzanat |
Portuguese | Tumefacção do escroto |
French | Tuméfaction du scrotum |
German | Skrotumschwellung |
Ontology: Swelling of inguinal region (C0476313)
Concepts | Finding (T033) |
SnomedCT | 207247004, 274743004, 102571004 |
English | [D]Groin swelling (context-dependent category), [D]Groin swelling, inguinal swelling, groin swelling (symptom), groin swelling, Swelling of inguinal region (finding), Groin swelling, Groin swelling (finding), Swelling of inguinal region, groin swollen, swelling groin, swelling inguinal, swelling of groin, swollen groin, Swelling of groin, [D]Groin swelling (situation), Inguinal swelling, Swollen groin |
Dutch | lies zwelling |
French | Tuméfaction de l'aine |
German | Leistenschwellung |
Italian | Tumefazione inguinale |
Portuguese | Tumefacção inguinal |
Spanish | Hinchazón inguinal, [D]tumefacción en la ingle (categoría dependiente del contexto), tumefacción inguinal (hallazgo), tumefacción inguinal, tumefacción de región inguinal (hallazgo), tumefacción de región inguinal, tumefacción de la región inguinal, tumefacción de la región inguinal (hallazgo), [D]tumefacción en la ingle (situación), [D]tumefacción inguinal, [D]tumefacción en la ingle, hinchazón de la ingle, hinchazón de la región inguinal (hallazgo), hinchazón de la región inguinal, hinchazón inguinal |
Japanese | 鼡径部腫脹, ソケイブシュチョウ |
Czech | Tříselné zduření |
Hungarian | Lágyék duzzanat |
Ontology: Swelling of testicle (finding) (C2584688)
Concepts | Finding (T033) |
SnomedCT | 87860000, 438457000, 236764007, 274756006, 198082005 |
Italian | Edema del testicolo |
English | Testicular swelling NOS, Swollen testis, Swelling of testicle, Swelling of testicle (finding), Swollen;testes, Testicular swelling NOS (disorder), Testicular swelling (finding), Testiclular swelling, Testicle swollen, Testicular swelling, swelling; testis, testis; swelling, Testicular swelling, NOS, swollen testes |
Japanese | 精巣腫脹, セイソウシュチョウ |
Czech | Otok varlete |
Spanish | tumefacción testicular (hallazgo), tumefacción testicular, tumefacción de testículo, edema testicular, SAI (trastorno), edema testicular, SAI, Hinchazón testicular, hinchazón testicular |
Hungarian | Testicularis duzzanat |
Dutch | testis; zwelling, zwelling; testis, testiculaire zwelling |
Portuguese | Tumefacção testicular |
French | Tuméfaction du testicule |
German | Hodenschwellung |