Acute Scrotal Pain in Pediatric Emergency Medicine: Assessment, Diagnosis, Management, and Treatment

Acute scrotal pain is frequently encountered within pediatric emergency medicine and requires thoughtful and timely evaluation. The differential diagnosis for scrotal pain is broad and includes conditions such as epididymitis, torsion of the appendix testis, testicular torsion, trauma, and incarcerated hernia. Some of these conditions represent surgical emergencies and thus need to be identified expeditiously. Obtaining a careful history and physical examination is essential to the evaluation of a child with acute scrotal pain. A good clinical history and examination in combination with appropriate diagnostic tests provide the best method for obtaining an accurate diagnosis. Using 2 case-based scenarios, we will discuss important conditions, components to the evaluation, and management of a child with acute scrotal pain.