Testicular Pain - Case Study Example

Past medical history (PMH) should include any history of STDs, single or multiple infections, treatment, and residual problems if applicable as well as concomitant diseases like Diabetes Mellitus or for any neurologic or vascular impairment (Seidel, et.al, 2006). Relevant to ask in the Family History are infertilities in siblings, history of penile, prostate and testicular cancer, and hernias (Siedel, et.al, 2006). Information as to the social history should also include past or present use of alcohol, drugs, and cigarette.

Since the patient rides a bike everyday and engages in physical sports (softball), the use of protective gear on his genital area should be asked. The patient's sexual history should include the number of sexual partners, condom usage, sexual lifestyle (heterosexual, homosexual, bisexual), and questions as to any change in the frequency of sexual desire or activity and change in sexual response (e.g. longer time needed to have an erection/ejaculation) should also be raised.Focused Scenario 2 3Physical examination should be done primarily on the patient's reproductive system.

The abdominal, perineal, and rectal areas should also be checked as to their proximity to the affected area. The presence of blood and other abnormal discharges should also be inspected. Under ocular inspection, the skin on the penis, scrotum, inguinal and perineal areas should be checked for any redness, skin discolorations, bruises, and swelling. Under palpation, any tenderness, lumpiness, unusual thickening, and nodules should be noted especially around the testicular area. For this patient, he should be checked for the presence of an inguinal hernia by palpating the inguinal canal.

A bright penlight can be used to transilluminate any masses found in the scrotum. This can help differential whether it is filled with liquid, gas, or solid material (Seidel, et.al, 2006). The clinical inferences made on this patient include testicular trauma which is most probable, due to the fact that the patient rides a bike everyday and engages in physical sports. Another is epididymitis as it is the most common cause of testicular pain in men older than 18 years (Zirkin & Thomas, 2005).

An indirect inguinal area is also possible since it can exit the external ring and pass into the scrotum. Hydrocele (fluid accumulation in the tunica), spermatocele (cystic swelling on the epididymis), and varicocele (abnormal dilatation of the pampiniform plexus) can also be differential diagnoses since these conditions may also present with testicular pain.Focused Scenario 2 4