Hypogonadism differential diagnosis: Difference between revisions
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* Treatment of cryptorchidism is mainly surgical in order to reduce the risk of malignancy | * Treatment of cryptorchidism is mainly surgical in order to reduce the risk of malignancy | ||
* | * [[Orchiopexy]] surgery is recommended in order to reposition the undecsended testes. | ||
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| rowspan="2" |Male diseases | | rowspan="2" |Male diseases | ||
|Testicular torsion | |[[Testicular torsion]] | ||
|Patients of testicular torsion usually present with following:<ref name="pmid19679025">{{cite journal| author=Schmitz D, Safranek S| title=Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion? | journal=J Fam Pract | year= 2009 | volume= 58 | issue= 8 | pages= 433-4 | pmid=19679025 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19679025 }}</ref> | |Patients of testicular torsion usually present with following:<ref name="pmid19679025">{{cite journal| author=Schmitz D, Safranek S| title=Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion? | journal=J Fam Pract | year= 2009 | volume= 58 | issue= 8 | pages= 433-4 | pmid=19679025 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19679025 }}</ref> | ||
* Sudden onset of severe pain in one [[testicle]], with or without a previous predisposing event | * Sudden onset of severe [[pain]] in one [[testicle]], with or without a previous predisposing event | ||
* Swelling within one side of the scrotum (scrotal swelling) | * [[Swelling]] within one side of the [[scrotum]] (scrotal swelling) | ||
* [[Nausea]] or [[vomiting]] | * [[Nausea]] or [[vomiting]] | ||
* [[Lightheadedness]] | * [[Lightheadedness]] | ||
* Bell clapper deformity of testes on examination | * Bell clapper deformity of [[testes]] on examination | ||
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* Scrotal ultrasound | * Scrotal [[ultrasound]] | ||
* Urinalysis to exclude bacterial infection | * [[Urinalysis]] to exclude [[bacterial infection]] | ||
|Management is mainly surgical through detorsion and fixation of the affected testes. | |Management is mainly surgical through detorsion and fixation of the affected [[testes]]. | ||
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|Orchitis | |[[Orchitis]] | ||
|Clincial features of orchitis include the following:<ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |year=2009 |pmid=19378875 |doi= |url=}}</ref><ref name="pmid21490048">{{cite journal |vauthors=Stewart A, Ubee SS, Davies H |title=Epididymo-orchitis |journal=BMJ |volume=342 |issue= |pages=d1543 |year=2011 |pmid=21490048 |doi= |url=}}</ref> | |Clincial features of orchitis include the following:<ref name="pmid19378875">{{cite journal |vauthors=Trojian TH, Lishnak TS, Heiman D |title=Epididymitis and orchitis: an overview |journal=Am Fam Physician |volume=79 |issue=7 |pages=583–7 |year=2009 |pmid=19378875 |doi= |url=}}</ref><ref name="pmid21490048">{{cite journal |vauthors=Stewart A, Ubee SS, Davies H |title=Epididymo-orchitis |journal=BMJ |volume=342 |issue= |pages=d1543 |year=2011 |pmid=21490048 |doi= |url=}}</ref> | ||
* [[Scrotum|Scrotal]] | * [[Scrotum|Scrotal]] [[swelling]] | ||
* Scrotal pain | * [[Scrotal pain]] | ||
* Lower urinary tract infections | * [[Lower urinary tract infections|urinary tract infections]] | ||
* Nausea, vomiting and chills | * [[Nausea]], [[vomiting]] and [[chills]] | ||
* [[Prehn's sign]] positive | * [[Prehn's sign]] positive | ||
* [[Costovertebral]] angle [[tenderness]] | * [[Costovertebral]] angle [[tenderness]] | ||
* Fever | * [[Fever]] | ||
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* [[Urethral]] [[Gram stain]] | * [[Urethral]] [[Gram stain]] | ||
* [[Urinalysis]] | * [[Urinalysis]] | ||
* [[Urine culture]] | * [[Urine culture]] | ||
* PCR to detect the presence of ''[[Neisseria gonorrheae]]'' and ''[[Chlamydia trachomatis]]'' | * [[PCR]] to detect the presence of ''[[Neisseria gonorrheae]]'' and ''[[Chlamydia trachomatis]]'' | ||
* Scrotal ultrasound is the diagnostic imaging of choice in cases of acute scrotum. | * Scrotal ultrasound is the diagnostic imaging of choice in cases of [[acute scrotum]]. | ||
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* [[Bed rest]] and limitation of [[physical activity]] | * [[Bed rest]] and limitation of [[physical activity]] | ||
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* [[Analgesia]] | * [[Analgesia]] | ||
* [[Non-steroidal anti-inflammatory drugs]] ([[NSAIDs]]) | * [[Non-steroidal anti-inflammatory drugs]] ([[NSAIDs]]) | ||
* [[Levofloxacin]] in bacterial infeciton. | * [[Levofloxacin]] in [[bacterial infeciton]]. | ||
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| rowspan="3" |Female diseases | | rowspan="3" |Female diseases | ||
|Polycystic ovarian syndrome (PCOS) | |[[Polycystic ovarian syndrome]] (PCOS) | ||
|Possible clinical findings in cases of PCOS:<ref name="AMN">{{cite web | author = Christine Cortet-Rudelli, Didier Dewailly | title =Diagnosis of Hyperandrogenism in Female Adolescents| work =Hyperandrogenism in Adolescent Girls | url=http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-in-female/ | year = 2006 | month= Sep 21 | publisher=Armenian Health Network, Health.am}}</ref> | |Possible clinical findings in cases of PCOS:<ref name="AMN">{{cite web | author = Christine Cortet-Rudelli, Didier Dewailly | title =Diagnosis of Hyperandrogenism in Female Adolescents| work =Hyperandrogenism in Adolescent Girls | url=http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-in-female/ | year = 2006 | month= Sep 21 | publisher=Armenian Health Network, Health.am}}</ref> | ||
* Amenorrhea | * [[Amenorrhea]] | ||
* Oligoamenorrhea | * [[Oligoamenorrhea]] | ||
* Ovarian cysts | * [[Ovarian cysts]] | ||
* Pelvic pain | * [[Pelvic pain]] | ||
* Dysparuenia | * [[Dysparuenia]] | ||
* Acne | * [[Acne]] | ||
* Hirsutism | * [[Hirsutism]] | ||
* Anxiety and depression | * [[Anxiety]] and [[depression]] | ||
* Sleep apnea | * [[Sleep apnea]] | ||
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* Blood testosterone level | * Blood [[testosterone]] level | ||
* LH and FSH levels | * [[LH]] and [[FSH]] levels | ||
* Pelvic ultrasound | * Pelvic ultrasound | ||
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* [[Spironolactone]] | * [[Spironolactone]] | ||
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|Pelvic inflammatory disease | |[[Pelvic inflammatory disease]] | ||
|Patients usually present with the following:<ref name="pmid25992748">{{cite journal |vauthors=Brunham RC, Gottlieb SL, Paavonen J |title=Pelvic inflammatory disease |journal=N. Engl. J. Med. |volume=372 |issue=21 |pages=2039–48 |year=2015 |pmid=25992748 |doi=10.1056/NEJMra1411426 |url=}}</ref><ref name="pmid27107781">{{cite journal |vauthors=Ford GW, Decker CF |title=Pelvic inflammatory disease |journal=Dis Mon |volume=62 |issue=8 |pages=301–5 |year=2016 |pmid=27107781 |doi=10.1016/j.disamonth.2016.03.015 |url=}}</ref> | |Patients usually present with the following:<ref name="pmid25992748">{{cite journal |vauthors=Brunham RC, Gottlieb SL, Paavonen J |title=Pelvic inflammatory disease |journal=N. Engl. J. Med. |volume=372 |issue=21 |pages=2039–48 |year=2015 |pmid=25992748 |doi=10.1056/NEJMra1411426 |url=}}</ref><ref name="pmid27107781">{{cite journal |vauthors=Ford GW, Decker CF |title=Pelvic inflammatory disease |journal=Dis Mon |volume=62 |issue=8 |pages=301–5 |year=2016 |pmid=27107781 |doi=10.1016/j.disamonth.2016.03.015 |url=}}</ref> | ||
* Bilateral abdominal pain | * Bilateral abdominal pain | ||
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* Hospitalization | * Hospitalization | ||
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|Endometriosis | |[[Endometriosis]] | ||
|Clinical features of endometriosis include the following:<ref name="pmid11949938">{{cite journal| author=Murphy AA| title=Clinical aspects of endometriosis. | journal=Ann N Y Acad Sci | year= 2002 | volume= 955 | issue= | pages= 1-10; discussion 34-6, 396-406 | pmid=11949938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11949938 }}</ref> | |Clinical features of endometriosis include the following:<ref name="pmid11949938">{{cite journal| author=Murphy AA| title=Clinical aspects of endometriosis. | journal=Ann N Y Acad Sci | year= 2002 | volume= 955 | issue= | pages= 1-10; discussion 34-6, 396-406 | pmid=11949938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11949938 }}</ref> | ||
* [[Dyspareunia]] | * [[Dyspareunia]] | ||
Revision as of 15:39, 1 August 2017
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Hypogonadism Microchapters |
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Diagnosis |
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Treatment |
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Hypogonadism differential diagnosis On the Web |
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American Roentgen Ray Society Images of Hypogonadism differential diagnosis |
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Risk calculators and risk factors for Hypogonadism differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Hypogonadism must be differentiated from diseases that cause delayed puberty or infertility. These diseases include congenital diseases as Klinefelter syndrome, Kallmann syndrome and cryptorchidism. The diseases include also testicular torsion and orchitis in males, polycystic ovary syndrome, pelvic inflammatory disease, and endometriosis in females.
Differentiating Hypogonadism from other Diseases
Hypogonadism must be differentiated from diseases that cause delayed puberty or infertility. These diseases include congenital diseases as Klinefelter syndrome, Kallmann syndrome and cryptorchidism. The diseases include also testicular torsion and orchitis in males, polycystic ovary syndrome, pelvic inflammatory disease, and endometriosis in females.
| Diseases | Clinical findings | Diagnosis | Manangement | |
|---|---|---|---|---|
| Congenital diseases | Klinefelter syndrome | Clinical features of Klinefelter syndrome are as the following:[1]
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| Kallmann syndrome | Clinical features of Kallmann syndrome include:
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| Cryptorchidism | Clinical features of cryptorchidism include:[2]
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| Male diseases | Testicular torsion | Patients of testicular torsion usually present with following:[3] |
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Management is mainly surgical through detorsion and fixation of the affected testes. |
| Orchitis | Clincial features of orchitis include the following:[4][5]
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| Female diseases | Polycystic ovarian syndrome (PCOS) | Possible clinical findings in cases of PCOS:[6] |
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| Pelvic inflammatory disease | Patients usually present with the following:[8][9]
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| Endometriosis | Clinical features of endometriosis include the following:[10]
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Medical therapy:
Surgery:
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References
- ↑ Denschlag, Dominik, MD; Clemens, Tempfer, MD; Kunze, Myriam, MD; Wolff, Gerhard, MD; Keck, Christoph, MD (October 2004), "Assisted reproductive techniques in patients with Klinefelter syndrome: A critical review", Fertility and Sterility, 82 (4): 775–779, doi:10.1016/j.fertnstert.2003.09.085
- ↑ Virtanen HE, Bjerknes R, Cortes D, Jørgensen N, Rajpert-De Meyts E, Thorsson AV; et al. (2007). "Cryptorchidism: classification, prevalence and long-term consequences". Acta Paediatr. 96 (5): 611–6. doi:10.1111/j.1651-2227.2007.00241.x. PMID 17462053.
- ↑ Schmitz D, Safranek S (2009). "Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion?". J Fam Pract. 58 (8): 433–4. PMID 19679025.
- ↑ Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.
- ↑ Stewart A, Ubee SS, Davies H (2011). "Epididymo-orchitis". BMJ. 342: d1543. PMID 21490048.
- ↑ Christine Cortet-Rudelli, Didier Dewailly (2006). "Diagnosis of Hyperandrogenism in Female Adolescents". Hyperandrogenism in Adolescent Girls. Armenian Health Network, Health.am. Unknown parameter
|month=ignored (help) - ↑ Legro RS, Barnhart HX, Schlaff WD (2007). "Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome". N Engl J Med. 356 (6): 551–566. PMID 17287476.
- ↑ Brunham RC, Gottlieb SL, Paavonen J (2015). "Pelvic inflammatory disease". N. Engl. J. Med. 372 (21): 2039–48. doi:10.1056/NEJMra1411426. PMID 25992748.
- ↑ Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
- ↑ Murphy AA (2002). "Clinical aspects of endometriosis". Ann N Y Acad Sci. 955: 1–10, discussion 34-6, 396–406. PMID 11949938.