Diagnoses not to be missed. Torsion of the testis

An acutely tender painful testis is likely to be a torsion, particularly in the boy before or at the time of puberty. In the older patient the lie of the other testis may give a clue to the diagnosis of torsion and at any age the history of previous "warning" episodes should be sought. Operation as soon as possible and always within 5 hours of the onset of pain is mandatory. The other testis should always be fixed. There is no place for treating small boys with antibiotics on the assumption of a diagnosis of epididymitis.