Investigations
With a clear cut history, keeping patients nil by mouth and early referral to urology is needed to facilitate exploration and detorsion. This is a time critical treatment and no specific investigations are needed (torsion is likely to occur in a population that has a low comorbidity burden).
In less clear cases, or where there is repeat attendances, the surgical team may consider ultrasound imaging but this should be left to local policies. Prompt referral and escalation should be the default position.