Physical Exam Key Points

1. Torsion of testis or epididymal appendage. Localized scrotal erythema, pinpoint tenderness in apex of testis (testis otherwise normal), and indurated and tender appendix. Early on, "blue dot sign," or torsed ischemic appendix, may be visible below noninflamed scrotal skin. Reactive hydrocele and progressive epididymal involvement and inflammation (secondary epididymitis) may preclude determination of this condition on physical exam, and may resemble torsion of testis cord on examination. Scrotal wall edema prevents transillumination as condition progresses.

2. Torsion of cord. Indurated, high-riding testis with possible transverse lie; diffuse tenderness. Does not transilluminate.

Incarcerated hernia. Enlarged, tender inguinal bulge that extends into scrotum.

Epididymitis. Tenderness is maximal at base of epididymis. Progressive involvement obliterates epididymal-testicular landmarks. Must exclude UTI.

Hydrocele. May be evident as nontender, bluish, fluid-filled sac surrounding testis. Hydrocele can be decompressed by gently pressing on its walls. Transilluminates readily. Testis tumor. Indurated, firm, nontender mass; 20% of patients have an associated hydrocele. If tumor is hormonally active, physical findings suggestive of precocious puberty may be present.

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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