Usually these patients are flagged up in triage as having a personal problem, but may well come in with UTI symptoms or feeling generally unwell. Focused history taking and appropriate questioning should highlight the key points to glean:
Timing and nature of pertinent symptoms
Previous infections and sexual health
Recent sexual history
Comorbidities
Key features are usually that of a unilaterally swollen and painful scrotum with erythema and associated tenderness and swelling of the epididymis.