ED Pathway for Child with Acute Non-Traumatic Scrotal Pain

Complete H&P

History Pain
  • Onset
  • Duration
  • Location
  • Migration
  • Severity (use pain scale)
Anorexia/Nausea
  • Last meal
  • Oral intake since symptom onset
Vomiting
  • Time of onset
  • Last episode
  • Number of episodes
Urine
  • Dysuria
  • Quantify urine output
  • Hesitancy
  • Urgency
  • Hematuria
Sexual History
  • Sexually active?
  • History of STIs
  • Urethral discharge
Fever
  • Duration
  • Medications given
Trauma
Past Medical History Prior episodes of testicular pain, surgeries, hernia
Physical Examination Abdomen
  • Focal tenderness
  • Guarding/rebound
  • CVA tenderness
Genital
  • Tanner stage
  • Inguinal canal abnormality
  • Scrotal tenderness
  • Lie of testicles, tenderness of testicles (focal pain?)
  • Abnormal color of scrotum
  • Differences in size
  • Presence/absence of cremasteric reflex
  • Unilateral pain