paraphrase and avoid AI patterns: While a critical diagnosis to rule out due to its surgical urgency, torsion is less likely in this case. Testicular torsion typically presents with sudden onset severe pain, high-riding testicle, absent cremasteric reflex, and nausea/vomiting. In this patient, the pain developed gradually, the cremasteric reflex is intact bilaterally, and the testicle remains in its normal vertical orientation, making torsion unlikely but still important to exclude promptly if symptoms change