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Testicular torsion
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== History - == * sudden onset, severe, constant, unilateral testicular pain in a young man * May be preceded by trauma or exercise * Much less common pre-pubertal - in this age group, more reasonable to order an USS and go from there, given torted appendage is main differential Exam - generally exquisitely tender testis, may be high-riding or transverse lie, may be oedematous, cremasteric reflex is not that sensitive. May feel tender twisted cord. Erythema of scrotum may be absent early. Elevation of testis may worsen pain or not help, whereas it is supposed to improve the pain of epididymo-orchitis. * Cremasteric reflex: afferent femoral branch of genitofemoral, efferent genital branch of genitofemoral.
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