Family Nurse Practitioner Exam

Which clinical finding can mimic testicular torsion but is not an emergency?

1. The "blue dot" sign

2. One swollen testicle with yellow-colored penile discharge

3. An acute onset of dysuria and frequency

4. A varicocele

The correct answer is: The "blue dot" sign

The "blue dot" sign is associated with torsion of the appendix testis, which occurs when the small vestigial structure at the upper pole of the testis twists. This condition can present with similar symptoms to testicular torsion, including acute scrotal pain and swelling, but it is not a surgical emergency. If an examination reveals the "blue dot" sign, it indicates ischemia and necrosis of the appendix testis rather than the complete vascular compromise characteristic of testicular torsion. In contrast, the other clinical findings mentioned either indicate a more urgent condition or do not resemble testicular torsion closely enough. One swollen testicle with yellow-colored penile discharge usually points towards an infection, such as epididymitis or sexually transmitted infections, which require prompt attention. An acute onset of dysuria and frequency suggests a urinary tract infection or prostatitis, both of which can also necessitate immediate care. A varicocele may present with testicular swelling but typically does not mimic the acute presentation of torsion and is generally a chronic condition.