This 15 year old male presented with several hours history of left testicular pain.
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An infarcted testicle with a twisted vascular pedicle/cord.
An orchiectomy was necessary.
Testicular torsion is a urological emergency - failure to recognize and perform a surgical exploration will result as in this case with a infarcted testicle.
Don't 'hit the sack' during on-call with a query of testicular torsion - get to theater and save the testicle.
Ultrasound can be supportive, but it should not alone dictate the clinician's decision to explore the scrotum.
In this case an orchiectomy was undertaken - the boat had been missed.