This article on acute scrotum reaffirms several previously documented features of this diagnosis and provides several new ones. In the end, the diagnosis of testicular torsion should be based on the clinical presentation and supported by the adjunct use of imaging studies, whether Doppler ultrasound or nuclear scintigraphy when time permits. As shown here, and confirmed by investigators who evaluate and treat these boys, the physical examination may not always secure the diagnosis depending on the level of cooperation by the child, and the examination skills of the examiner.
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