Summary of Common Conditions Seen in OSCEs
| Testicular mass | How to differentiate |
| Testicular tumour | Woody hard/firm |
| Smooth or craggy surface | |
| Not separate from testicle | |
| Not transilluminable | |
| Can get above it | |
| Patient is young to middle-aged | |
| May show signs related to side effects of chemotherapy (e.g. hair loss) | |
| Inguinal hernia (usually indirect) | Cannot get above it |
| Does not transilluminate | |
| Above and medial to the pubic tubercle | |
| Can be controlled once reduced by pressure on the deep inguinal ring | |
| Epididymal cyst | Separate from testicle |
| Transilluminates | |
| Varicocele | ‘Bag of worms’ consistency |
| Seen when standing and disappears on lying down | |
Left-sided is more common:
| |
| Penile ulcer | May be on glans (so retract foreskin) |
| Offer to take a swab for microscopy, culture and sensitivity | |
| Hydrocele | Soft, smooth, not separate from testicle |
| Transilluminates | |
| Cannot get above it |
Making a Diagnosis
The algorithm in Figure 13.1 will help you make a diagnosis quickly and systematically.
Figure 13.1 Algorithm for making a good diagnosis
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