Let’s twist again…the acute scrotum and torsion

Author: Shah M. Rahman/ Editor: Jon Bailey, Ed Norris-Cervetto / Codes:  / Published: 02/12/2021

This session is about the assessment and management of patients presenting with testicular pain to the Emergency Department. 

By the end of this session, you should be able to:

  • List common differentials for acute scrotal pain
  • Describe the pathophysiology of acute scrotal pain differentials
  • Explain the management of testicular torsion and epididymo-orchitis
  • Recognise features indicative of synergistic gangrene or trauma
  • Recall and understand the role of investigations, including ultrasound, in the evaluation of testicular pain


  1. Barada, James, Weingarten, Jeffrey and Cromie W. Testicular Salvage and Age-Related Delay in the Presentation of Testicular Torsion. J Urol. 1989;142(3):7468. 
  2. Beni-Israel T, Goldman M, Chaim S, Kozer E. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010;28(7):7869. 
  3. Sorensen MD, Krieger JN, Rivara FP, Broghammer JA, Klein MB, Mack CD, et al. Fourniers Gangrene: Population Based Epidemiology and Outcomes. NIH Public Access. 2011;181(5):21206. 
  4. Kleanthous C, Gavalas M. Chaperones in Emergency Departments. 2015;(March)

Additional Resources:

coreem.net testicular-torsion

patient.info scrotal lumps pain and swelling

canadiem.org urological disorders

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