Red flags The following findings are of particular concern: Sudden onset of pain; exquisite tenderness; and a high-riding, horizontally displaced testis (testicular torsion) Inguinal or scrotal nonreducible mass with severe pain, vomiting, and constipation (incarcerated hernia) Scrotal or perineal erythema, necrotic or blistered skin lesions, and toxic appearance (Fournier gangrene) Sudden onset of pain, hypotension, weak pulse, pallor, dizziness, and confusion (ruptured abdominal aortic aneurysm) Interpretation of findings The focus is to distinguish causes that require immediate treatment from others.