Question:
An 8 year old boy has testicular pain of gradual onset over the last three days. The pain is localized to the upper pole with a positive cremasteric reflex. A hard, tender nodule of less than 5mm in size is palpable in this region. On inspection there is a small bluish discoloration and localised tenderness in the upper pole of the testes. Doppler ultrasonography reveals a small nodule adjacent to the upper pole of the testis and normal vascularity. The most appropriate next step would be
a) prompt surgical exploration
b) needle aspiration
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