Scrotal mass and discomfort (dullness/heaviness)
Physical exam
"Bag of worms"
More prominent with standing or Valsalva
Does not trans-illuminate
"Bag of worms"
More prominent with standing or Valsalva
Does not trans-illuminate
Varicocele
Scrotal cellulitis
Hematocele
Epididymitis
Hydrocele
Fournier gangrene
Hydrocele 
Inguinal hernia 