strangulated hernia, inguinal or femoral - tender, painful, irreducible groin lump. May present as intestinal obstruction or abdominal pain
torsion of the testis - a sudden onset unilateral scrotal pain. There may be an associated poorly-localised abdominal pain. In an early presentation the testis lies high in the scrotum, is exquisitely tender and the spermatic cord is thickened. The opposite testis may lie horizontally - bell-clapper testis
torsion of the hydatid of Morgagni - again this is a sudden onset unilateral scrotal pain. However in this case there is only tenderness at the upper pole of the testis, and the testis hangs normally
acute epididymitis - moderate or severe scrotal pain and tenderness; also marked redness and oedema. There is often a history indicative of a previous urinary tract infection
haematocoele - eg following trauma or scrotal surgery for vasectomy
appendicitis: the appendix has the same visceral afferent nerve supply (T10) as the testes and this can cause referred pain
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