Which sign is negative in testicular torsion and positive in epididymo-orchitis?

• A. Prehn Sign
• B. Cremasteric Reflex
• C. Phren's Sign
• D. No Sign

Answer: (A)

Pain relief with scrotal elevation differentiates torsion from epididymo-orchitis. This is Prehn sign: when you lift the scrotum, pain improves in epididymo-orchitis because the inflammatory swelling is somewhat relieved by elevation, whereas in testicular torsion the ischemic pain does not improve, so the sign is negative. That makes it the best choice for distinguishing between the two conditions.

The cremasteric reflex is typically absent in torsion and can be present in epididymo-orchitis, but this sign is less specific and not the classic feature used to separate the two. Phren's sign is not a reliable or commonly used differentiator, and saying no sign would not help distinguish these conditions.