Pain is a very different clinical entity depending on whether it is acute or chronic. Two articles in this issue of The Journal address these 2 sides of diagnosing and treating scrotal pain.The most compelling diagnosis in patients with acute scrotal pain is testicular torsion. Certainly there are patients in whom a diagnosis of torsion can be made solely on clinical grounds and have no need for imaging. The history of acute onset of testicular pain, nausea and vomiting, along with findings of abnormal or absent cremasteric reflex and high riding testis are suggestive of torsion.
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