Last reviewed: 5 Jul 2021
Last updated: 09 Feb 2018
Summary
Definition
History and exam
Key diagnostic factors
- testicular pain
- intermittent or acute on-and-off pain
- no pain relief upon elevation of scrotum
- scrotal swelling or edema
- scrotal erythema
- reactive hydrocele
- high-riding testicle
- horizontal lie
- absent cremasteric reflex
Other diagnostic factors
- nausea and vomiting
- abdominal pain
- fever
- urinary frequency
Risk factors
- age <25 years
- neonate
- bell clapper deformity
- trauma/exercise
- intermittent testicular pain
- undescended testicle
- cold weather
Diagnostic investigations
1st investigations to order
- gray-scale ultrasound
- power Doppler ultrasound
- color Doppler ultrasound
Investigations to consider
- spectral Doppler
- urinalysis
- CBC
- CRP
- scintigraphy
Treatment algorithm
Contributors
Authors
George Kaplan, MD
Professor of Surgery
Department of Surgery
UC San Diego School of Medicine
San Diego
CA
Disclosures
GK declares that he has no competing interests.
Acknowledgements
Dr George Kaplan would like to gratefully acknowledge Dr Deborah Dean and Dr Paul Hamilton, the previous contributors to this monograph. DD and PH declare that they have no competing interests.
Peer reviewers
Eugene Minevich, MD, FAAP, FACS
Associate Professor
Division of Pediatric Urology
Cincinnati Children's Hospital Medical Center
Cincinnati
OH
Disclosures
EM declares that he has no competing interests.
Simon E. Kenny, BSc, ChB (Hons), MD, FRCS (Paed), FAAP
Consultant Pediatric Surgeon/Urologist
Alder Hey Children's NHS Foundation Trust
Liverpool
UK
Disclosures
SEK declares that he has no competing interests.
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