TESTICULAR ATROPHY

TESTICULAR ATROPHY: Excerpt from Differential Diagnosis in Primary Care

The causes of this sign can best be recalled by using the mnemonic VINDICATE.

TESTICULAR ATROPHY

1. V—Vascular conditions bring to mind varicoceles, which cause atrophy on the side of the dilated veins.
2. I—Inflammation recalls the atrophy following mumps, orchitis, and other causes of epidydimoorchitis.
3. N—Neoplasms suggest the atrophy that occurs in the estrogen treatment of prostatic carcinoma.
4. D—Degenerative suggests the atrophy resulting from aging.
5. I—Intoxication should remind one of the atrophy resulting from chronic alcoholism, Lannec cirrhosis, and hemochromatosis. X-ray exposure may also produce atrophy.
6. C—Congenital recalls undescended testes and torsion.
7. A—Autoimmune and allergic suggest nothing.
8. T—Trauma reminds one of the atrophy following vasectomy and accidental ligation of the blood supply during hernia repair.
9. E—Endocrine suggests the atrophy of hypopituitarism, Klinefelter syndrome, and other eunuchoidal states.

Approach to the Diagnosis

The workup of testicular atrophy may require a chromatin analysis, serum testosterone, FSH and LH levels, and biopsy, but referral to an endocrinologist is the best way to get this accomplished with accuracy.

Other Useful Tests

1. Sperm count
2. VDRL (syphilis)
3. Serum iron and iron binding capacity (hemochromatosis)
4. Liver biopsy (hemochromatosis)
5. EMG (myotonic dystrophy)
6. Urology consult
7. CT scan of the brain (pituitary insufficiency)

Book Source Details

• Book Title: Differential Diagnosis in Primary Care
• Author(s): R. Douglas Collins
• Year of Publication: 2007
• Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Differential Diagnosis in Primary Care Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 0-7817-6812-8

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