Emergency Department Clinical Pathway for Children with
Acute Non-Traumatic Scrotal/Testicular Pain

High Probability Testicular Torsion

  • Post-pubertal patient
  • Abnormal lie of testicle (high riding, horizontal)
  • Cremasteric reflex absent
  • Moderate to severe pain
  • Nausea/vomiting

Low Probability Testicular Torsion

  • Pre-pubertal patient
  • Normal lie of testicle
  • Cremasteric reflex present
  • Mild to moderate pain
  • No nausea /vomiting
Posted: July 2011
Revised: October 2011, January 2016 (Reviewed), May 2018 (Reviewed)
Authors: R. Scarfone, MD; J. Lavelle, MD; K. Posner, MD; K. Kraf, MD
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