MLA Domain 5 · Presentation

Scrotal/ testicular pain and/ or lump/ swelling

5 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 3

Epididymo-orchitis

SUDDEN severe pain in a young man → exclude testicular torsion (surgical emergency, <6h) FIRST

Hydrocoele, varicocoele & epididymal cyst

A hydrocoele that obscures the testis, or any doubt → ultrasound to exclude an underlying tumour (especially new in a yo

Prostatitis, epididymitis & orchitis

Cannot reliably exclude TORSION → if any doubt (especially sudden onset in a young man), explore surgically — torsion is

recognised feature · 1

Scabies

Crusted (Norwegian) scabies — thick hyperkeratotic crusts teeming with mites, often minimal itch, highly contagious, in

differential of the above · 1

Testicular torsion

It is a CLINICAL diagnosis → immediate surgical exploration; do NOT delay for an ultrasound — the testis infarcts within