Differentiation of inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests: prospective study.

OBJECTIVE: The differential diagnosis of an acute scrotum is of great importance in clinical practice and may be difficult in some cases. The aim of this study was to differentiate inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests which can be performed quickly and easily outside a hospital setting.

PATIENTS AND METHODS: From 2007 to 2010, 85 boys with acute scrotum were included in this prospective study. There were 28 boys with inflammatory and 57 with non-inflammatory causes. We investigated the role of erythrocyte sedimentation rate, C-reactive protein, leukocyte, white blood cell differential count, alkaline phosphatase, creatine kinase and child's age in differential diagnosis of the acute scrotum, differentiating inflammatory from non-inflammatory causes of the disease. We used receiver operating characteristics (ROC) analysis and logistic regression analysis.

RESULTS: Statistically significant parameters in accurate differentiation between inflammatory and non-inflammatory causes of the acute scrotum were C-reactive protein (p = 0.001) and child's age (p < 0.001). These two parameters yielded the probability of an inflammatory outcome in the etiology of acute scrotum with sensitivity of 75% and specificity of 69.1%.

CONCLUSION: C-reactive protein and child's age are helpful in differentiating inflammatory from non-inflammatory causes of the acute scrotum.