Testicular pain is a common presentation to the Emergency Department. Patients presenting with testicular pain should be rapidly assessed and assumed to have testicular torsion until proven otherwise. Torsion occurs in 1/4000 under 25 year olds, is a surgical emergency and if not assessed and operated on within 6 hours can result in irreversible damage. Untreated torsion can lead to testicular ischaemia, infarction, subfertility and the potential need for orchidectomy. 

What challenges does scrotal pain present to the emergency physician?

Challenges for the emergency physician can include difficulty in confirming or refuting the diagnosis. It is vital the Emergency physician can appropriately recognise testicular torsion as a potential diagnosis and promptly refer to the acute surgical team for further assessment and management. 

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