Urinalysis
Pyuria seen in half of cases
Urine culture (children, elderly men)
Urine GC/Chlam (urethral discharge or age <40)
Ultrasound for equivocal cases
Older men should be evaluated for urinary retention
Pyuria seen in half of cases
Based on clinical exam or ultrasound
Epididymitis
Scrotal cellulitis
Traumatic epididymitis
Testicular torsion
Fournier gangrene
Spermatocele
Hematocele
Hydrocele 