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Testicular torsion — RACP Paediatrics MCQ

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EasyEmergency paediatricsTesticular torsionRACP Paediatrics

A 13-year-old boy has sudden severe testicular pain with nausea. The affected testis is high-riding and horizontal, and the cremasteric reflex is absent. Urinalysis is normal. What is the most appropriate management?

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Correct answer: A — Immediate surgical exploration

This is testicular torsion until proven otherwise, and urgent surgical exploration should not be delayed by imaging when clinical suspicion is high. Normal urinalysis and absent cremasteric reflex make epididymo-orchitis less likely. The pearl is that salvage depends on time, so early surgical involvement is the key intervention.

Reference: RCH Clinical Practice Guidelines: Acute scrotal pain; Therapeutic Guidelines (eTG)