Case scenario: 26-year-old male with right scrotal pain and swelling.

room with acute onset of right-sided scrotal pain. The pain awoke him from sleep approximately 2 hours prior to presentation and began in the right lower quadrant, then quickly localized to the scrotum. With the onset of pain he noted swelling of the right testicle. There was no fever, chills, nausea, or vomiting. Upon examination, the abdomen was benign. The right scrotum appeared mildly enlarged. Palpation revealed a thickened spermatic cord and a mildly enlarged but tender testicle. The epididymis was palpated in the anterolateral part of the scrotum. The cremasteric reflex could not be demonstrated on either side. Initial laboratory tests including urinalysis were normal except for mild leukocytosis. CASE SCENARIO