A 21-year-old man comes to the emergency department because of a 3-day history of progressively worsening right scrotal pain. He says the pain started 3 days ago when he woke up. At first, the pain was a minor annoyance, but it has gradually increased in intensity to the point that it is now somewhat uncomfortable to walk. He has also noted a gradual swelling of his right scrotum but denies penile discharge, urinary frequency, dysuria, hematuria, or fevers. He denies any trauma to the area. He competed in a basketball game the previous evening but did not feel as though he strained himself during the game. He denies experiencing anything like this in the past. He has taken acetaminophen for the scrotal pain without any relief.
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