Question

An 18-year-old male presents with profound scrotal pain. Which of the following findings supports a diagnosis of testicular torsion?

a) Positive Prehn's sign
b) High fever
c) Profound neutrophilia
d) Loss of the cremasteric reflex

Answer 1

The finding that supports a diagnosis of testicular torsion is the loss of the cremasteric reflex. The other symptoms listed are not typically associated with torsion but may indicate infections like epididymitis or orchitis.

Step-by-step explanation:

The correct answer supporting a diagnosis of testicular torsion in an 18-year-old male with profound scrotal pain is d) Loss of the cremasteric reflex. Testicular torsion is an emergency where the testis twists on itself, affecting blood flow. This condition does not typically present with fever or neutrophilia, as would be expected in infectious processes like epididymitis or orchitis. A positive Prehn's sign is more commonly associated with epididymitis, indicating relief of pain when the scrotum is lifted, which does not support testicular torsion.

In contrast, the loss of the cremasteric reflex, an involuntary reflex where the testicle temporarily rises in response to stroking the inner thigh, is a key indication that torsion may have occurred.