Diagnosing Testicular Torsion before Urological Consultation and Imaging: Validation of the TWIST Score

The Journal of Urology
Kunj R ShethLinda A Baker

Abstract

The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score uses urological history and physical examination to assess risk of testis torsion. Parameters include testis swelling (2 points), hard testis (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding testis (1). While TWIST has been validated when scored by urologists, its diagnostic accuracy among nonurological providers is unknown. We assessed the usefulness of the TWIST score when determined by nonurological nonphysician providers, mirroring emergency room evaluation of acute scrotal pain. Children with unilateral acute scrotum were prospectively enrolled in a National Institutes of Health clinical trial. After undergoing basic history and physical examination training, emergency medical technicians calculated TWIST score and determined Tanner stage per pictorial diagram. Clinical torsion was confirmed by surgical exploration. All data were captured into REDCap™ and ROC curves were used to evaluate the diagnostic usefulness of TWIST. Of 128 patients (mean age 11.3 years) 44 (13.0 years) had torsion. TWIST score cutoff values of 0 and 6 derived from ROC analysis identified 31 high, 57 intermediate and 40 low risk cases (positive predictive va...Continue Reading

Associated Clinical Trials

References

Nov 5, 2002·Pediatric Surgery International·H F McAndrewI Gollow
Jul 31, 2003·BJU International·A J Visser, C F Heyns
Aug 2, 2003·Journal of Pediatric Surgery·Caleb P NelsonDavid A Bloom
Apr 17, 2008·International Journal of Clinical Practice·S Kapoor
Sep 15, 2010·The American Journal of Emergency Medicine·Tali Beni-IsraelEran Kozer
Apr 30, 2011·The Journal of Urology·Nicholas G CostLinda A Baker
May 25, 2011·World Journal of Urology·G LiguoriC Trombetta
Mar 6, 2012·Urology·Michael BoettcherDaniel C Aronson
Oct 30, 2012·The Journal of Urology·João A BarbosaHiep T Nguyen
Mar 19, 2013·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Edgar M EspanaArun D Singh
Apr 27, 2013·AJR. American Journal of Roentgenology·Teresa LiangMichelle Noga
Jul 6, 2013·BJU International·Michael BoettcherKonrad Reinshagen

❮ Previous
Next ❯

Citations

Mar 21, 2016·The Journal of Urology·João Arthur Brunhara Alves BarbosaHiep T Nguyen
Oct 5, 2016·The Journal of Urology·Aderivaldo Cabral Dias FilhoPaulo Gonçalves Oliveira
Nov 18, 2017·Journal of Paediatrics and Child Health·Craig A McBride, Bhaveshkumar Patel
Aug 24, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Lillian C FrohlichLois K Lee
Aug 18, 2018·Emergency Medicine Journal : EMJ·Alex Ridgway, Peter Hulme
Aug 8, 2020·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Aderivaldo Cabral DiasCassio Luis Zanettini Riccetto
Oct 1, 2020·American Journal of Men's Health·Akinori NakayamaHiroshi Okada
Aug 28, 2020·International Urology and Nephrology·João Arthur Brunhara Alves BarbosaMarco Antonio Arap
Dec 6, 2020·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·R I Kylat
Oct 30, 2020·Open Access Emergency Medicine : OAEM·Abdullah LaherAhmed Adam
Dec 29, 2020·Frontiers in Pediatrics·Michaela KlinkeMichael Boettcher
Feb 5, 2021·Acta chirurgica Belgica·Antoine SteemanPierre Youatou Towo
Dec 17, 2017·The Journal of Pediatrics·Michelle K ArevaloLinda A Baker
Apr 22, 2017·The Journal of Pediatrics·Christopher E BayneH G Rushton
Dec 16, 2020·Journal of Pediatric Urology·Milan GopalHaitham Dagash
Aug 10, 2021·Scandinavian Journal of Urology·Karl Teurneau-HermanssonMagnus Wagenius
Oct 3, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Hideki TakeshitaSatoru Kawakami

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

American Family Physician
Victoria J SharpAngela M Arlen
Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Manish I ShahDonna R Mendez
European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie
A O CiftciN Büyükpamukçu
© 2021 Meta ULC. All rights reserved