A 12-Year-Old Boy Is Brought to the Emergency Department Due

A 12-year-old boy is brought to the emergency department due to scrotal pain.  Three hours ago, the patient performed a cannonball dive into a swimming pool.  He felt immediate, sharp pain in his scrotum after hitting the water.  The patient placed a cold compress to the area and took ibuprofen, but the pain persisted.  He has no medical conditions and takes no medications.  Temperature is 37.2 C (99 F) , blood pressure is 120/85 mm Hg, respirations are 26/min, and pulse is 120/min.  Physical examination shows an uncomfortable-appearing boy who is bent forward at the waist.  Edema, faint ecchymosis, and tenderness are evident along the right hemiscrotum.  The remainder of the examination is unremarkable.  Which of the following is the best next step in management of this patient?

A) Abdominal and pelvic CT scan
B) Doppler ultrasound of scrotum
C) Oxycodone and observation
D) Scrotal elevation and support
E) Surgical evacuation of hematoma

Correct Answer:

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