A young man presented with right testicular pain. The pain had initially occurred two days previously. As he did not think it was "too severe" and it had settled spontaneously, he had not sought medical review. On the day of presentation, the pain recurred , which he described as "moderate".
The right testicle is enlarged and hetrogenous. There is no flow seen on color Doppler within the testicle. Note the presence of color flow around the testicle, which does not exclude torsion.
The presentation in this case with "moderate" and "not too severe" pain is unusual for torsion. The patient underwent emergency exploration of the scrotum which confirmed the diagnosis of torsion but the testicle was non-viable and a right orchidectomy was performed.