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Case Report Volume 14 Issue 2
Testicular pain with normal doppler ultrasound: a diagnostic trap of intermittent torsion
Ahemdi Chrive Ahmed, Moncef El Midaoui, Youssef Maachi, Babty Mouftah, Amine Slaoui, Tariq Karmouni, Abdellatif Koutani, Khalid El Khader
Received: June 15, 2026 | Published: July 14, 2026
Citation: Ahmed AC, Midaoui ME, Maachi Y, et al. Testicular pain with normal doppler ultrasound: a diagnostic trap of intermittent torsion. Urol Nephrol Open Access J. 2026;14(2):53-55. DOI: 10.15406/unoaj.2026.14.00373
Abstract
Background: Testicular torsion is a urological emergency requiring prompt surgical intervention. Doppler ultrasound is the standard diagnostic tool; however, its sensitivity is imperfect, particularly in cases of intermittent or early torsion where blood flow may be partially or transiently preserved. Case Presentation: We report the case of a 16-year-old male presenting with acute-onset left scrotal pain. Physical examination revealed significant testicular tenderness, an elevated and horizontally positioned testis, and an absent cremasteric reflex. Doppler ultrasound demonstrated preserved intratesticular blood flow with no sonographic evidence of torsion. Given the high clinical suspicion, urgent surgical exploration was performed and revealed an intermittent torsion with a 360-degree twist that had spontaneously reduced. The testis showed early ischemic changes. Detorsion and bilateral orchidopexy were performed successfully. Conclusion: Normal Doppler ultrasound does not exclude testicular torsion. In the context of acute scrotal pain with characteristic clinical findings, surgical exploration must not be delayed by reassuring imaging. Clinical suspicion remains the primary determinant for urgent intervention.
Keywords: testicular torsion, intermittent torsion, doppler ultrasound, acute scrotum, surgical exploration, false negative imaging
©2026 Ahmed, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.