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©2013 UpToDate ® Print Email Torsion of the appendix testis The appendix testis is a 0.3 cm pedunculated structure on the anterosuperior aspect of the testis. Torsion can produce testicular pain that ranges from mild to severe. Infarction and necrosis of the appendix testis can be seen as a "blue dot" sign (arrow) in 21 percent of cases. Reproduced with permission from Charise Johns, MD.