Muscular pain at a spot on the chest wall or on a muscle group is difficult to evaluate.If it is on the chest wall many causes especially heart pain , pain originating from the respiratory system and pain from the ribs are to be excluded.There after fibromyalgia will come into picture . It may be a part a part of Rheumatoid Arthritis.Rheumatoid muscular pain does occur along with joint pain.It can be diagnosed by investigations like Rheumatoid Factor,ESR ,X-Rays examinations and clinical findings.If suggestive investigations found to be positive diagnosis of fibromyalgia becomes easy.If no other diseases as mentioned above are found we also level it to be fibromyalgia.It treated by simple analgesics.And if Rheumatoid is found it is not treated separately.
I do not remember if I have seen bilateral orchitis in the recent past that I saw to-day.The enlargement is quite remarkable.May be it is due to the delay in arrival to the hospital.Orchitis is inflammation of testis commonly by bacteria in an adult but in tropical countries usually filarial. .In children it is usually of viral in origin.Here the testis enlarges and becomes painful accompanied by fever.Epididymis is also involved most of the times.It follows an urinary tract infection through backward infection.
Support of testis,analgesics to relieve the pain and antibiotics to control infection are required.Investigations like urine examination along with culture and sensitivity test and ultrasonography of testis and abdomen are important to support treatment.
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