Acute testicular pain is a common presentation in young adults at the Emergency setting, and is associated with a range of differential diagnosis including testicular torsion, infection, trauma, and other uncommon causes such as tumors. Testicular torsion is a major cause of testicular infarction  and thus rapid assessment is required to exclude it. Once testicular torsion is excluded, the ER physician may proceed to a full patient history and physical examination to diagnose the source of the testicular pain. The patient’s age, history of trauma, infectouse symptoms  and urinary symptoms are necessary to orient the physician to the appropriate diagnostic path. A physical exam of the scrotal abnormalities may reveal inflammatory (epididymitis, epididymo-orchitis, abscess) or traumatic signs. Nevertheless, history taking and physical examination are often not sufficient for definite diagnosis due to pain or swelling that can limit an accurate physical examination. Therefor the use of Ultrasound with color Doppler and power Doppler imaging can greatly enhance the accuracy of the diagnosis and differentiate surgically correctable abnormalities from those that can be adequately treated by medical therapy alone. The aim of this study was to investigate the frequency of the different etiologies of acute scrotal pain along with ultrasound and clinical findings in young men presenting with acute scrotal pain at AUBMC in Beirut, Lebanon.

The present prospective study was based on 94 patients between the ages 18 and 40 presenting to the ER at AUB-MC with acute scrotum.