“No discriminating features in either history of examination conclusively differentiate the correct diagnosis”(Sidler 1997)
Take Home Points
- Consider the diagnosis of testicular torsion in all patients with acute testicular pain
- Testicular torsion is a surgical emergency that requires immediate urologic consultation to increase the rate of tissue salvage.
- History, physical examination and ultrasound are all flawed in making the diagnosis. The gold standard is surgical exploration
- Consider manual detorsion in patients where consultation will be delayed