What is the role of lab testing in the diagnosis of acute epididymitis?

Updated: Apr 04, 2018
  • Author: Michelle DiMare, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

A study by Asgari et al suggested that C-reactive protein (CRP) levels and the erythrocyte sedimentation rate (ESR) may be useful in differentiating epididymitis from testicular torsion. In the prospective study, the investigators evaluated 120 patients with the diagnosis of an acute scrotum; serum CRP and ESR were drawn at the time of admission. Of the 46 patients diagnosed with epididymitis, 44 (95.6%) had elevation of the CRP level, while of the 23 with torsion, 1 (4%) had elevation of the CRP level. Of the 51 other patients with other noninflammatory causes of acute scrotum, none had significant elevation of the CRP level. In addition, the ESR was highest in the epididymitis group. The authors proposed cutoff values for distinguishing epididymitis from noninflammatory causes of acute scrotum of 24 mg/L for the CRP level and 15.5 mm/h for the ESR. [18]

As with bedside ultrasonography, the use of ESR and CRP is promising, but further investigations are necessary.


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