Last reviewed: March 2019
Last updated: February  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
Full details

Other diagnostic factors

  • nausea and vomiting
  • abdominal pain
  • fever
  • urinary frequency
Full details

Risk factors

  • age <25 years
  • neonate
  • bell clapper deformity
  • trauma/exercise
  • intermittent testicular pain
  • undescended testicle
  • cold weather
Full details

Diagnostic investigations

1st investigations to order

  • gray-scale ultrasound
  • power Doppler ultrasound
  • color Doppler ultrasound
Full details

Investigations to consider

  • spectral Doppler
  • urinalysis
  • CBC
  • CRP
  • scintigraphy
Full details

Treatment algorithm

ACUTE

non-neonate

neonate

Contributors

Authors VIEW ALL

Professor of Surgery

Department of Surgery

UC San Diego School of Medicine

San Diego

CA

Disclosures

GK declares that he has no competing interests.

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 VIEW ALL

Associate Professor

Division of Pediatric Urology

Cincinnati Children's Hospital Medical Center

Cincinnati

OH

Disclosures

EM declares that he has no competing interests.

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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