Abstract
A 45-year-old male presented to the emergency department with an acute onset of severe lumbosacral pain and scrotum pain. Despite initial differential diagnoses, including testicular torsion, perineal necrotizing fasciitis, and acute epididymitis, subsequent imaging revealed a burst fracture of the 12th thoracic vertebra. This case highlights the importance of considering vertebral compression fractures in the differential diagnosis of acute scrotum pain, especially in patients with atypical presentations.