II. Causes: Groin Swelling

  1. Undescended Testicle (Cryptorchidism)
  2. Femoral or inguinal adenitis or adenopathy
  3. Femoral arterial aneurysm
  4. Inguinal Hernia
  5. Femoral Hernia
  6. Hematoma
  7. Hidradenitis Suppurativa
  8. Lipoma
  9. Lymphoma
  10. Metastatic cancer
  11. Psoas abscess
  12. Sebaceous Cyst

III. Causes: Generalized Edema

IV. Causes: Skin Lesions

V. Causes: Scrotal, Testicular or Epididymis Swelling

  1. See Scrotal Pain
  2. Acute and Tender
    1. Testicular Torsion
      1. Acute unilateral Scrotal Swelling and Scrotal Pain
      2. Pain not relieved with Prehn's Sign (unreliable)
      3. Associated with a high riding Testicle and Nausea or Vomiting
    2. Torsion of Testicular Appendage
      1. Acute, gradual onset of intense pain at the superior pole of the Testicle
      2. Blue dot sign (blue discoloration at the Testicle's superior pole) is pathognomonic
    3. Orchitis or Epididymitis
      1. Acute unilateral Scrotal Swelling and pain adjacent to Testicle and may be relieved with Prehn's Sign
      2. May be associated with Dysuria, fever, scrotal erythema
      3. Increased C-Reactive Protein (CRP) >24 mg/ml in most cases
  3. Chronic and Non-tender
    1. Varicocele
      1. Soft lumps superior to the Testicle (bag of worms), esp. in left Scrotum
      2. Dull ache or heaviness Sensation may be present, worse with standing or Valsalva Maneuver
    2. Testicular carcinoma
      1. Firm, unilateral Nodule (may present with pain in some cases)
    3. Hydrocele
      1. Mobile, ovoid, non-tender Scrotal Mass superior or adjacent to the Testicle
      2. Fluid collection around the Testicle that transilluminates
    4. Hematocele
      1. Trauma induced blood collection around Testicle (evaluate for testicular rupture)
    5. Spermatocele
      1. Palpable swelling within the spermatic cord, often near the Testicle (typically after Vasectomy)
    6. Inguinal Hernia
      1. Soft mass in the Scrotum or Inguinal Canal
      2. Indirect Inguinal Hernia often palpable with Valsalva Maneuver
    7. Epidermoid Cyst
      1. Asymptomatic, firm, round Nodule beneath the skin surface
      2. Cyst contains foul smelling, cottage cheese material

VI. Causes: Spermatic cord swelling

  1. Indirect Inguinal Hernia
    1. Typically unilateral bulging of Scrotum provoked with Valsalva Maneuver
  2. Varicocele
    1. Dull ache-type Scrotal Pain provoked with standing
    2. "Bag of worms" like swelling
  3. Hydrocele
    1. Fluid collection around the Testicle that transilluminates

VII. History

  1. Is pain present?
  2. Timing (acute or chronic)?
  3. Exacerbating and palliative factors?
  4. Associated constitutional symptoms (e.g. fever, chills, Night Sweats, weight loss)?
  5. Abdominal Pain?
  6. Dysuria?
  7. Hematuria?

VIII. Exam

  1. Palpate Testicle and spermatic cord for Nodules or masses
  2. Cremasteric Reflex
  3. Prehn Sign
  4. Inguinal Canal palpation with Valsalva Maneuver
  5. Transillumination of the Scrotum (Hydrocele allows light transmission)

IX. Imaging: Scrotal Ultrasound with Doppler Imaging

  1. Scrotal Ultrasound is indicated in most cases of Scrotal Mass
  2. Testicular Torsion is an emergency and requires immediate evaluation

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Related Studies

Ontology: Scrotal mass (C0149774)

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