19th April 2022

A 20 year old male university student presents to A+E with a 1 day history of unilateral scrotal pain

A 20 year old male university student presents to A+E with a 1 day history of unilateral scrotal pain. He claims this began when he woke up, and it has been increasing in intensity throughout the day. There is no preceding trauma to his testicles, and he is sexually active, with his last partner being 1 week ago. He did not use barrier contraceptives in this instance. He has experienced no bowel issues, but finds the pain gets worse during urination. He doesn’t think that he has had any urethral discharge.

On examination the scrotum has overlying erythematous skin changes, with the right testicles seemingly enlarged. The patient finds the area tender on light palpation. There is no transillumination of the area. There is some relief when there is physical support of the scrotum, and cremasteric reflex is patent.

What is the likely diagnosis for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.