Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the testicle's blood supply, a condition called ischemia. The principal symptom is rapid onset of testicular pain. The most common underlying cause is acongenital malformation known as a "bell-clapper deformity" wherein the testis is inadequately affixed to the scrotum allowing it to move freely on its axis and susceptible to induced twisting of the cord and its vessels.
The diagnosis should usually be made on the presenting signs and symptomsand an urgent ultrasound should only be done when the diagnosis is unclear. Irreversible ischemia begins around six hours after onset and emergency diagnosis and treatment is required within this time to minimize the risk of testicle loss.
It is most common just after birth and during puberty.]It occurs in about 1 in 4,000 to 1 per 25,000 males per year before 25 years of age.
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http://www.aafp.org/afp/2013/1215/p835.html testicular torsion: diagnosis, evaluation, and management by victoria j. sharp, md, mba, and kathleen kieran, md, university of iowa carver college of medicine, iowa city, iowa angela m. arlen, md, children's healthcare of atlanta and emory university, atlanta, georgia am fam physician. 2013 dec 15;88(12):835-840.
http://www.hindawi.com/journals/criu/2016/6017636/ satoshi funada, ryosuke ikeuchi, toru yoshida, and takehiko segawa, “seminoma in a man with russell-silver syndrome presenting with testicular torsion,” case reports in urology, vol. 2016, article id 6017636, 3 pages, 2016. doi:10.1155/2016/6017636
http://www.jebmh.com/data_pdf/09%20-%20anand%20-%204.pdf anand morri, p. v. sri ramachandra murthy, siva sankar rao kurra. “torsion testis: role of color doppler: a study of 50 cases”. journal of evidence based medicine and healthcare; volume 2, issue 40, october 05, 2015; page: 6635-6638, doi: 10.18410/jebmh/2015/905
http://www.hindawi.com/journals/criu/2014/212914/ bioku muftau jimoh, eziechila bessie chinwe, adewumi oluwafemi adebisi, igwilo chinwe ifeoma, maduka ogechi, and aiyekomogbon joshua oluwafemi, “idiopathic scrotal hematoma in neonate: a case report and review of the literature,” case reports in urology, vol. 2014, article id 212914, 3 pages, 2014. doi:10.1155/2014/212914