A 28-year-old man presents with symptoms of testicular pain. He indicates that two days before evaluation he was lifting and moving heavy gym equipment. He describes the pain as having developed in the scrotum but now radiates along the spermatic cord.
On exam, he is exquisitely tender along the posterior portion of the left scrotum, where a single enlarged, tender mass is palpated. The inguinal canals are normal to palpation and Prehn’s sign is positive.
Which of the following is the most likely diagnosis?
C. Indirect hernia
D. Renal calculi
E. Testicular torsion