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Testicular torsion — USMLE Step 3 MCQ

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HardEmergency MedicineTesticular torsionUSMLE Step 3

A 16-year-old has abrupt severe unilateral testicular pain, vomiting, a high-riding testis, and an absent cremasteric reflex. Urinalysis is normal. Which action is best?

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Correct answer: A — Obtain urologic consultation for scrotal exploration during emergency evaluation

This is classic testicular torsion. Immediate urologic assessment and exploration should not be delayed for imaging when clinical suspicion is high; alternative diagnoses must not postpone salvage.

Reference: American Pediatric Surgical Association: Testicular Torsion: https://apsapedsurg.org/parents/learn-about-a-condition/p-z/