Testicular Swelling: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing): skin and mucous membranes.
    • Inspection and palpation (palpation) of abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, guarding tension?, hernial orifices?, renal bearing knocking pain?) [abdominal mass?]; exclusion of supraclavicular lymph nodes (“above the clavicle/clavicle”)?, lymph nodes in the inguinal region (groin region)?, the inguinal region (groin region) etc. [thickened swelling in the inguinal region may indicate incarcerated inguinal hernia/incarcerated inguinal hernia; lymph node metastases?]
    • Inspection and palpation of genitals (penis and scrotum) [testicular location, size, and painfulness compared to opposite side or where is the punctum maximum of pain):
      • [Orchitis: there is a reddened and swollen scrotum (scrotum); palpatorily, there is enlargement/swelling (edema), induration, and tenderness of the testis; Prehn’s sign is usually positive; however, this is not definite clinical evidence of orchitis
      • Testicular torsion: dark blue to black discoloration of the testis; often the testis is fixed on the affected side close to the body or lies transversely, due to the torsion of the shortened spermatic cord/Brunzel’s sign: fixed, painful, horizontal protrusion of the testis in the presence of testicular torsion]
      • Testicular tumor [(coarse), painless unilateral swelling of the testis?]

      [due todifferential diagnosis “hydatidentorsion”: in a diaphanoscopy (fluoroscopy of the scrotum with light) are often found in such cases so-called “blue dot sign” (bluish shimmering structures), as an indication of a circulatory disorder of the appendices of the testis or epididymis].

    • Digital rectal examination (DRU): examination of the rectum and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency.

    Square brackets [ ] indicate possible pathological (pathological) physical findings.