Question
was seen by family md 9/10/10 for lower right abdominal pain and right sided scrotal swelling.  sent to the ed for cbc and scrotal us.  dx of epiditymitis orchitis.  2 days prior,  engaged in tough core workout with bosu ball and many compound movements.  day after workout, diffuse abdominal pain,  deep right lower quadrant pain.  pain increased the following day,  went to the ed.  after follow up with urologist, told prostatitis.  urine clean. after  7 days methl pred pack and 14 levaquin, still discomfort to right anterior hip, right lower abdomen, ache to right side of scrotum/testicle upon palpation.  placed on 2nd course of levaquin for 14 more days.  eventually hip pain lessened,  but right scrotum/testicle still aches.  urologist ordrered ct.  findings were possible femoracetebular impingement,  sent to ortho.  1st ortho seemed bit confused,  saw 2nd ortho.  after many xrays and tests and 1st mri, bilateral fai with possible labral tear.  sports hernia was also questioned, ruled out by surgeon richard cattey in WI. can this condition cause pain to the scrotum/testicles? i have an mri anthrogram this weak to zone in on the right hip pathology.   thanks

Answer
Dear Chris,

I can understand why you are confused. It is hard when there appears to be no good answer for the troubles that we are going through. The good news is that you are having a lot of good doctors taking long hard looks at you.  It appears that they are trying to get to the bottom of your problem. We always hear about how "scientific" health care is, but sometimes it boils down to trial and error. Remember, these doctors are all just human beings. They are taking their vast knowledge and experience and trying to make sense of your circumstances. They will and do make mistakes, and their diagnosis is nothing more than their best educated guess.

The primary concern for me is the scrotal swelling. I am sure that they are doing this, but they need to make sure that you are not having any strangulation of testicles, testicular masses, etc.  These could be serious.

Check this out, if you haven't already:  http://www.nlm.nih.gov/medlineplus/ency/article/003160.htm

As far as the hip pain causing scrotal pain... anything is possible, so make sure that you follow through and take a look at the hips. The bad news is that hip joint problems can exist without any pain as well. So in other words, even if they find a hip pathology, there is no guarantee that it is the cause of your pain.

Another place that your doctors might consider looking is at the lower back area. The lowest part of the spine is the area the supplies nerve intervention to the groin and scrotum. A problem in that area could be referring symptoms into the scrotum. It is worth a look.

Good luck. I find this case interesting. When you get the results back from the MRI, please give me an update?

I hope that you get to the reason for your pain and discomfort soon. Keep me informed.

Keith Biggs, DC
http://www.eastmesachiropractor.com