1)      Neonate with an inconsolable crying episode, similar to past recurrent episodes with spontaneous resolution (testicular torsion needs exclusion)

2)      Postpubertal child with acute scrotum, past similar recurrent episodes with spontaneous resolution (needs exclusion of testicular torsion)

3)      Early adolescence with acute scrotum (torsion of appendices of testes and epididymis)

4)      Epididymitis of childhood – exclude sexually transmitted diseases

5)      Acute scrotal pain with absent cremasteric reflex – a pinch or light upstrokes in the superior medial aspect of thighs elicit elevation of the ipsilateral testicle.  This reflex is absent in the  testicular torsion