ACR Appropriateness Criteria ® acute onset of scrotal pain--without trauma, without antecedent mass

Ultrasound Quarterly
Erick M RemerBoaz Karmazyn

Abstract

Men or boys, who present with acute scrotal pain without prior trauma or a known mass, most commonly suffer from torsion of the spermatic cord; epididymitis or epididymoorchitis; or torsion of the testicular appendages. Less common causes of pain include a strangulated hernia, segmental testicular infarction, or a previously undiagnosed testicular tumor. Ultrasound is the study of choice to distinguish these disorders; it has supplanted Tc-99 m scrotal scintigraphy for the diagnosis of spermatic cord torsion. MRI should be used in a problem solving role if the ultrasound examination is inconclusive. The ACR Appropriateness Criteria ® are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

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Citations

Jun 14, 2008·AJR. American Journal of Roentgenology·Joseph W Stengel, Erick M Remer
May 16, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Laura L Avery, Meir H Scheinfeld
Aug 10, 2011·Pediatric Radiology·Cameron H Williams, Donald P Frush
Feb 17, 2018·Insights Into Imaging·Gian Carlo ParentiMelchiore Giganti
Aug 26, 2014·Ultrasound Quarterly·Joseph ZechlinskiGary Sudakoff
Nov 22, 2019·Abdominal Radiology·David E SweetErick M Remer
May 7, 2015·Ultrasound Quarterly·Joel P ThompsonDeborah Rubens
Apr 22, 2018·Emergency Radiology·Christopher R McAdams, Andrew J Del Gaizo
Aug 11, 2020·The Pan African Medical Journal·Ismail Abdul Sattar BurudMahadevan Deva Tata

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