Testicular Torsion

HJ Paltiel, LP Connolly, A Atala, et al [ Harvard Med School, Boston; Yale Univ New Heaven, Conn]


Acute Scrotal Symptoms in Boyes with an Indeterminate Clinical Presentation : Comparision of Color Dopper Sonography and Scintigraphy 


Radiology 207: 223-231, 1998

   


Conclusions – Clinical examination and impression are the most important factors when one is evaluating for testicular torsion. Diagnostic testing is indicated only when the clinical suspicion of torsion is very low.

   


This article clearly shows that color Doppler scrotal sonography can miss testicular torsion. Although nuclear scintigraphy was more specific, it was incorrect in 1 of 11 cases of torsion. The authors recommend the use of scintigraphy when color Doppler US findings are indeterminate, but additional delay in obtaining a second diagnostic test in these cases may warrant surgical exploration.