<prompt> All predispose to torsion testis, except:Inversion testisEpididymo orchitisHigh investment of tunica vaginalisSeparation of epididymis from body of testis  <response>: Ans: b Epididymo orchitis Ref: Bailey Love, 24th ed, p. 1405Epididymo orchitis does not predispose to torsion testisPredisposing factors for torsion of testisa Inversion of the testis most commonb High investment of the tunica vaginalis cause testis to hang within the tunica like a clapper in a bellc Separation of the epididymis from the body of the testis permits torsion of the testis without involving the cord. Twisting is confined to the pedicle which connects the testis with the epididymisMost common bw 10 25 yrs of age- Prehn signOn elevation of testisPain increases - in torsionPain decreases -in epididymo orchitisPyuria is associated with Epididymo orchitis, not with torsion testisInv of choiceColour Doppler- detects the decreased blood flow to testis in torsionTc 99 pertechnate scan - demonstrates decreased blood flowTreatment:1 In the 1st hr torsion can be treated by manipulation, but later on surgery is done to fix testis2 If not correctable by manipulation or more than one hr has passed, then surgery has to be done. Surgery must be done within 4 hrs. otherwise testis will be dead.3 Both affected unaffected testis should undergo orchidopexy because anatomical variation responsible for torsion is likely to be bilateral. 