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Testicular torsion — MCCQE Part 1 MCQ

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EasyScrotal PainTesticular torsionMCCQE Part 1

A 16-year-old boy presents with sudden severe left testicular pain and vomiting. The testis is high-riding with an absent cremasteric reflex. Symptoms started 3 hours ago. What is the most appropriate next step in management?

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Correct answer: A — Urgent urologic exploration without delaying for ultrasound

Sudden testicular pain, vomiting, high-riding testis and absent cremasteric reflex indicate torsion, where testicular salvage depends on urgent exploration. Ultrasound can help equivocal cases but should not delay surgery when clinical suspicion is high. Epididymitis is less likely in this acute prepubertal-style presentation.

Reference: Canadian Urological Association resources; MCC Objectives—Scrotal Pain