The term "acute bursa" is a generic term used to describe a clinical situation characterized by the sudden or rapid onset of scrotal pain, which may be associated with swelling of the bursa. Acute bursitis in children is a frequent complaint in paediatric emergency departments. It is a clinical entity characterized by the onset of persistent, usually unilateral, scrotal pain. Other accompanying signs may also be present. It has always been considered a diagnostic and therapeutic emergency.Several pathologies can be the cause of acute bursal disease. Torsion of the spermatic cord dominates these etiologies, due to the risk of ischemia and testicular necrosis, which threaten the twisted testicle unless treated surgically as a matter of urgency. Some etiologies of acute bursal disease do not constitute true emergencies and do not even require surgical exploration. But the clinical similarities between testicular torsion and other causes of acute bursae mean that any painful bursa should be considered a testicular torsion until proven otherwise.