Diagnosis of Epididymitis and Orchitis
To diagnose severe, sudden testicular pain, the first step is to rule out testicular torsion (a medical emergency), which often involves using ultrasound. If the ultrasound is inconclusive, other tests for torsion may be needed.
Tests for epididymitis may include urine and blood tests to look for signs of infection. Physical examination may reveal swollen lymph nodes in the groin and a tender or enlarged prostate. If a sexually transmitted infection is possible, the doctor may perform a urethral smear (a swab from inside the urethra) to test for chlamydia and gonorrhea. In boys who have not reached puberty, a complete urologic assessment may be performed to look for underlying urinary tract abnormalities.