Which presentation is most typical for a patient with testicular torsion?

The presentation most characteristic of testicular torsion is the sudden onset of severe unilateral testicular pain. This acute condition occurs when the spermatic cord becomes twisted, cutting off the blood supply to the affected testicle. Patients often report an immediate and intense pain, frequently accompanied by nausea and vomiting, making the pain severity notable.

In contrast, other presentations, such as unilateral painless swelling or gradual increases in testicular pain, do not align with the acute nature of torsion. Pain that develops gradually, particularly if bilateral, is more typical of conditions like epididymitis rather than torsion. Persistent pruritus, or itching, is unrelated to testicular torsion and indicates a different condition altogether, primarily focusing on irritation rather than pain. Thus, the hallmark of testicular torsion is the abrupt and excruciating pain that necessitates urgent medical evaluation.