Inflamed vs varices: Pain is a result of inflammation or changes is circulation. It is unlikely (extremely rare) to have bilateral torsion. If you don't have bilateral inguinal hernias, you should consider undergoing a scrotal ultrasound to assess for increased flow suggesting epididymal orchitis, or changes in flow seen in varicoceles. If "-", then it could be a ligamentous strain.
Answered 4/6/2014
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