Examination of the groin and scrotum

33 Examination of the groin and scrotum

Questions

image How do you test for reducibility of an inguinal hernia?
image If a hernia extends into the scrotum, is it direct or indirect?
image What is a tense, fluctuant, brilliantly transilluminable testicular lump likely to be?

The groin

Introduction

The patient should be asked about any pain and then asked to stand up and unclothe from nipples to knees. The locations of groin hernias are shown in Fig. 3.5.1. Causes of groin lumps are:

image inguinal and femoral hernias
image lymph node: look for generalized lymphadenopathy
image lipoma: subcutaneous, mobile, variable size, may be fluctuant
image femoral aneurysm: expansile pulsation, may be bilateral
image lymphocele: following femoral artery surgery in the groin, the local lymphatics may become disrupted, and a local collection of lymphatic fluid forms a lump; it can be simply aspirated
image ectopic testis: the testis is absent from the scrotum; feeling along the line of the inguinal ligament should detect an undescended testes
image saphena varix: bluish tinge, has a cough impulse, disappears on lying; varicose veins may be present
image psoas abscess: in the psoas muscle (Crohn’s disease or tuberculosis): deep and fluctuant, causing fixed flexion of the hip.

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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Examination of the groin and scrotum

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