A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area.The boy's heart rate is 122 beats/minute, and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen, and the testes are firm to touch and tender, with extensive cremaster
muscle contraction noted. What is the boy's most likely diagnosis?
A) Epididymitis
B) Hydrocele
C) Testicular torsion
D) Varicocele
Ans:
C
Feedback:
The combination of the boy's age, signs, and symptoms is indicative of testicular torsion. Epididymitis normally lacks cremaster muscle involvement, and hydrocele is marked by massive distention of the scrotum. Varicocele is often asymptomatic or marked by heaviness in the scrotum.
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