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Imaging of Boys with an Acute Scrotum: Differentiation of Testicular Torsion from Other Causes

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Evidence-Based Imaging in Pediatrics

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Key Points

■ Testicular torsion is a clinical emergency. Time is the major factor responsible for salvage of testes (moderate evidence).

■ The first-line imaging of patients with suspected testicular torsion is Doppler sonography, which is highly sensitive and specific (moderate evidence).

■ Scintigraphy using technetium 99m to assess blood flow to the testes is no longer a common imaging tool due to the more available, less expensive, and rapid test with Doppler sonography (limited to moderate evidence).

■ If imaging cannot exclude testicular torsion, surgical exploration is recommended (moderate evidence).

■ Successful manual detorsion of testicular torsion leads to reperfusion, which is immediately visible with Doppler sonography. In cases of successful manual detorsion, surgical exploration with orchiopexy is still necessary (limited evidence).

■ Absolute dependence on clinical features can lead to a misdiagnosis of testicular torsion. Therefore, US examination should be part of the presurgical evaluation, if promptly available (limited evidence).

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Authors and Affiliations

  1. Research Programm on Evidence-Based Diagnostics, Institute of Public Health, Paracelsus Private Medical University, A-5020, Salzburg, Austria

    Stefan Puig

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  1. Stefan Puig
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Correspondence to Stefan Puig .

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Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Puig, S. (2010). Imaging of Boys with an Acute Scrotum: Differentiation of Testicular Torsion from Other Causes. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_40

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  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_40

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