A 17-year-old male is brought to the emergency department by…
A 17-year-old male is brought to the emergency department by his parents at 11:30 PM reporting sudden onset of severe right-sided scrotal pain that woke him from sleep approximately 2 hours ago. He also reports associated right lower abdominal pain, one episode of nausea with vomiting, and denies any urinary symptoms, fever, or recent trauma. He is sexually active and denies urethral discharge. On physical exam, the right testicle is markedly tender, high-riding, and oriented in a horizontal lie. The cremasteric reflex is absent on the right. There is no overlying skin erythema or warmth. The left testicle is normal. Vitals: Temp 37.1 °C, HR 102 bpm, BP 126/74 mmHg Which of the following is the next most appropriate step?