4th September 2020

A 13-year-old boy presents to A+E with a 3-hour history of severe pain in the left scrotum

A 13-year-old boy presents to A+E with a 3-hour history of severe pain in the left scrotum. On examination, the testis has a normal lie, and there is no swelling or erythema. The cremasteric reflex is present, the blue dot sign is positive, and there is a small firm mass palpable at the superior pole of the testis. The boy is otherwise well and has no past medical history. From the clinical examination the A+E doctor strongly suspects a testicular appendage torsion, however, given the short time of presentation and severe nature of the pain, he wants to rule out the small possibility of a testicular torsion and orders an urgent ultrasound.

What finding on the US Doppler would make testicular torsion less likely?

Select the SINGLE most appropriate option from the list below. Select ONE option only.