Testicular torsion in the older patient

A 40-year-old man presented with severe right-sided scrotal pain and was proven to have a 720-degree right testicular torsion. Fewer than 50 documented cases of testicular torsion have been reported in men over the age of thirty. The anatomical predisposition for torsion generally selects these individuals early in life. Rapid diagnosis allowed for surgical correction and testicular salvage. We outline an expedient diagnostic approach for these difficult cases with use of the Doppler ultrasound and the technetium (99mTc) testicular scan.