Physical examination maneuver

Physical Exam

Cremasteric Reflex

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How to Perform

With the inner thigh and scrotum exposed, lightly stroke the skin of the upper medial thigh upward with a gloved fingertip. Watch for prompt contraction of the cremaster muscle with elevation of the ipsilateral testis. Repeat on the opposite side and record the reflex as present or absent.

How to Interpret

Showing 1 of 3 findings

Testicular Torsion

Absent cremasteric reflex in acute scrotal pain
Rule in
InconclusiveWide CI
Rule out
Somewhat helpfulWide CI
Evidence:ModerateResearch in progress

References

Research in progress on one or more findings above; ratings may change.

  • Prasad GR, Khan AU. Diagnostic Utility of the Absent Cremasteric Reflex and Prehn's Sign in Testicular Torsion: A Multicentre Retrospective Observational Study Comparing Clinical Examination with USG and Colour Doppler Imaging. J Clin Diagn Res. 2025;19(12):PC01-PC05. doi:10.7860/JCDR/2025/77982.22067. Free full text at jcdr.net.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.