Prehn's sign helps distinguish epididymitis from testicular torsion because lifting the testicles:

Prehn's sign helps distinguish epididymitis from testicular torsion because lifting the testicles:

• A. Relieves pain in torsion
• B. Relieves pain in epididymitis but not torsion
• C. Worsens pain in both conditions
• D. Has no diagnostic value

Answer: (B)

Prehn's sign relies on whether elevating the testicle changes the pain pattern. In epididymitis, the inflammatory process around the epididymis often makes pain that can lessen when the scrotum is elevated, presumably by reducing edema and venous congestion and lessening irritation of the inflamed tissue. In contrast, testicular torsion causes acute ischemia from twisting of the cord, and lifting the testicle does not relieve that ischemic pain, so the pain generally remains. Therefore, pain relief with elevation suggests epididymitis, while persistent pain with elevation points toward torsion. Keep in mind that this sign isn’t perfect, and ultrasound with Doppler is the preferred diagnostic tool when torsion is possible.

Prehn's sign relies on whether elevating the testicle changes the pain pattern. In epididymitis, the inflammatory process around the epididymis often makes pain that can lessen when the scrotum is elevated, presumably by reducing edema and venous congestion and lessening irritation of the inflamed tissue. In contrast, testicular torsion causes acute ischemia from twisting of the cord, and lifting the testicle does not relieve that ischemic pain, so the pain generally remains. Therefore, pain relief with elevation suggests epididymitis, while persistent pain with elevation points toward torsion. Keep in mind that this sign isn’t perfect, and ultrasound with Doppler is the preferred diagnostic tool when torsion is possible.