Case 3
Nerves
Could be: dorsal branch pudendal nerve, genitofemoral nerve, ilioinguinal nerve, and iliohypogastric nerve
palpation of the piriformis does not produce pain in the penis or scrotum
excludes pudendal nerve
normal cremasteric reflex
no genitofemoral nerve
iliohypogastric does not innervate the penis and scrotum
excludes iliohypogastric
based on symptoms compression of ilioinguinal nerve is the source of pain
L convexity and R rotation shown in the x-ray could increase possible compression of nerves passing between the psoas major muscle and L2-4 transverse processes when the trunk rotates to the right side with an ipsilateral stiff psoas major muscle.
Taut, tender structure was found
above the middle inguinal canal,
No urinary retention without willingness to urinate; no tingling and numbness
no caudal equina syndrome
Cancer
Acute onset, no unwanted weight loss/gain, no lumps, no night sweating
no cancer
Bones, Muscle
x-ray, and US: negative; muscles have no signs/symptoms of strain
no bone and muscles
Genital Disease
No genital abnormality, normal bilateral cremasteric reflexes
no genital disease
Urinary Disease
urine test, US, and x-ray: negative; no urgency, frequency, or pain during urination
no urinary disease
Herniation
blood test, equal strength, no LE inflammation, no lump and pain
no herniation
