Upon examination, a classic "blue-dot sign" (ie, a tender nodule with blue discoloration on the upper pole of the testis) may be seen; this finding on the upper scrotum is a typical finding in torsion of the appendix testis (see the image below). However, in the acute setting, differentiating testicular torsion from torsion of the appendix is often impossible, and scrotal exploration should be performed whenever the diagnosis is uncertain