Pearson: Clinical Case 3 Flashcards
What is seen on a PE of groin muscle strain?
Hip ROM
Flex/extend/ab/ad against resistance
Try to reproduce pain
What is incarceration?
incarceration- things get stuck not reversible, but everything works still
What is strangulation?
strangulation- thing get stuck, twist, no longer works
How do you asses a pt for incarceration/strangulation?
typically CT is used but ultrasound is getting better
Sometimes it’s a clinical diagnosis
What’s a differential for a M w/ groin pain?
- testicular torsion
- inguinal hernia (incarcerated/strangulated)
- groin muscle strain
- contusion trauma
- STI, UTI, infection
- Hydrocele
- Varicocele
- FEmoral nerve impingement
- malignancy
- lymphadenitis
- Referred pain
What is a hydrocele?
fluid filled scrotum, usually not painful
usually self resolves
communicating- between the scrotum that follows the track
What must you rule out with a hydrocele?
inflammatory hydrocele
What is a varicocele?
PE can feel “varicose veins” of scrotum, NOT painful
**can affect fertility
What is seen with femoral nerve impingement?
Pain that affects sensation/pain to anterior part of leg
Hip flexer, knee extender, patellar reflex
Femoral nerve pierces the psoas and runs underneath the inguinal ligament
*sometimes seen w/ trauma and overuse
What is seen w/ testicular malignancy?
slow onset
spectrum from asymptomatic to painful
What is testicular torsion?
When the testicle rotates on the spermatic cord. The rotation cuts off blood flow and cuases sudden often severe pain and swelling.
Often in males 10-25 y/o
How do you dx testicular torsion?
Doppler imaging showing decreased or absent blood flow to affected testicle
How do you tx testicular torsion?
surgery as soon as possible after sxs begin
The sooner the testicle is untwisted, the greater the chance of successful treatment:
Within six hours, the testicle can be saved about 90% of the time
After 12 hours, chances of saving the testicle fall to about 50%
After 24 hours, the testicle can be saved only about 10% of the time
What is done during a surgery to reverse testicular torsion?
Make a cut in the scrotum
Untwist the spermatic cord, if necessary
Stitch one or usually BOTH testicles to the inside of the scrotum to prevent rotation (the testicle on the non-affected side is usually also anchored as a preventive measure. This is because the non-affected testicle is at risk of testicular torsion in the future.)
What is typically found in a pt w/ epididymitis?
palpable tenderness more specifically over epididymis
