A skilled examiner may not be able to exclude testicular torsion by physical examination maneuvers in a patient who presents with acute scrotal pain. Diagnostic adjunctive studies may be of assistance. However, if a diagnosis cannot be established with certainty, surgical exploration is warranted. Patients with Henoch-Schönlein purpura who present with a vascular eruption on the scrotum, lack a rash elsewhere, and have no arthritis or hematuria are likely to be explored.