In a case of suspected testicular torsion, which additional physical exam finding is expected?

In cases of suspected testicular torsion, the absence of the cremasteric reflex on the affected side is a significant finding. The cremasteric reflex, which is the contraction of the cremaster muscle resulting in the elevation of the testicle when the inner thigh is stroked, typically remains intact if the testicle is not twisted. When testicular torsion occurs, blood flow to the testis is compromised, leading to ischemia and loss of this reflex due to nerve dysfunction.

Affected individuals often present with acute, severe scrotal pain, and upon physical examination, one would expect to find that the reflex does not elicit the expected response on the torsed side. This finding is crucial in differentiating testicular torsion from other conditions such as epididymitis, where the cremasteric reflex is usually preserved.

The confirmation of an absent cremasteric reflex can guide clinicians towards urgent surgical intervention, as testicular torsion is a medical emergency requiring timely management to prevent testicular necrosis. The lack of this reflex is an indicator of potential testicular compromise, making it a key physical exam finding in the context of suspected torsion.