In the neonatal age group, the testicle frequently has not yet descended into the scrotum and becomes attached within the tunica vaginalis. Additionally, this mobility of the testicle predisposes to torsion. Torsion more often involves the left testicle. Testicular torsion most often is observed in males younger than 30 years, with the majority aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
History includes a sudden onset of severe unilateral scrotal pain.
Onset of pain can occur more slowly, but this would be an uncommon presentation for torsion. Torsion can occur with activity, be related to trauma, or develop during sleep. The involved testicle is painful to palpation and frequently is elevated in position when compared to the other side. Fever is uncommon. Testicular torsion is a clinical diagnosis.