Pain History

A thorough pain history can establish if the pain is true acute onset testicular pain fitting with testicular torsion or is referred from other pathology. Acute onset of pain is typically associated with testicular torsion with one study recently finding sudden onset of pain was seen in 90% of patients with testicular torsion, in 69% of patients with appendix torsion, in 58% of patients with epididymitis, and in 78% of patients with normal scrotums(10).

Gradual onset pain is classically more likely to be torsion of the appendage, but may also correlate with a history of intermittent torsion.
Previous torsion and orchidopexy (which is typically done bilaterally) makes further torsion highly unlikely.