Other aspects of the history

Testicular torsion typically presents in a post-pubertal male with sudden onset severe, unilateral, testicular pain. There may be a history of similar episodes of self –limiting pain indicating spontaneous torsion and detorsion (intermittent torsion). Precipitants may be related to forceful contraction of the cremasteric muscle secondary to trauma, physical exertion, an erection or sudden coldness. Associated features include: anorexia, gastrointestinal upset and fevers(11).

Other causes of epididymo-orchitis to be aware of include mumps (fevers and parotid gland swelling) and vasculitides such as Buergers syndrome and Henoch-Schönlein purpura (rash and arthralgia).

The patients’ past medical history may reveal other differentials such as: hernias, renal stones, aortic abdominal aneurysm.

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