A 10 year old male was brought to OPD with a chief complaint of acute onset of left scrotal pain 3 hours earlier, which awoke him from sleep. The pain is constant and does not change with position. There is no history of trauma. He has no dysuria, fever, chills, nausea or vomiting. Primary Exam: He is afebrile in moderate distress secondary to left scrotal pain. The left hemiscrotum is edematous and erythematous.
The left testicle has a transverse lie, with marked tenderness to palpation. The cremasteric reflex is absent on the left.The right hemiscrotum and testicle are normal on exam. The circumcised penis is normal, with no urethral discharge present. A CBC and urinalysis are normal. Requesting your advice with the diagnosis and further tests.
