Pathogenesis: acute inflammation of the tunica vaginalis (acute serositis)
Key diagnostic features (Eshel et al)
(1) boy of Mediterranean origin with positive family history for FMF
(2) recurrent episodes of scrotal pain and/or swelling and/or tenderness
(3) gradual onset of fever, with body temperature > 37.5°C
(4) gradual onset of pain, often over 12 hours or more
An attack is usually:
(1) unilateral (occasionally bilateral)
(2) usually concurrent peritoneal inflammation is absent
(3) self-limited (lasts from 8 hours to 15 days)
Differential diagnosis:
(1) acute torsion (FMF does not preclude torsion)
Treatment with colchicine can prevent these attacks.
