THE ACUTE SCROTUM

When a pubertal child presents with a swollen, painful, tender testicl e that has been present for less than 12 hours and the history and phy sical examination suggests that torsion is the most likely diagnosis, urgent surgical exploration without additional testing is recommended. When the diagnosis is not clear or when the pain and swelling are of longer duration, diagnostic imaging is recommended. Color Doppler ultr asonography is our preferred imaging modality because of its ready ava ilability and diagnostic accuracy.