Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis

Pediatric Radiology
Anjum N Bandarkar, Anna R Blask

Abstract

Testicular sonography has contributed greatly to the preoperative diagnosis of testicular torsion in the pediatric patient and is the mainstay for evaluation of acute scrotal pain. Despite its high sensitivity and specificity, both false-negative and false-positive findings occur. Presence of documented Doppler flow within the testis might be a dissuading factor for surgical exploration with resultant testicular loss in the false-negative cases. Our goal is to illustrate key sonographic features in the spectrum of testicular torsion with preserved testicular flow, and to describe how to differentiate testicular torsion from epididymitis in order to avoid the under-diagnosis of testicular torsion. We simplify the anatomy of the bell clapper testis. We also describe our sonographic protocol for testicular torsion and share valuable tips from our approach to challenging cases.

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Citations

Jul 4, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Takahiro HosokawaYoshitake Yamada
Jan 1, 2020·The Journal of International Medical Research·Xiang GuoHui Guo
Mar 4, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Lauren F AlexanderShweta Bhatt
Feb 14, 2020·International Urology and Nephrology·Xian-Ling LiLi-Qun Jia
Oct 1, 2020·American Journal of Men's Health·Akinori NakayamaHiroshi Okada
Apr 1, 2019·Abdominal Radiology·Jeries P ZawaidehLorenzo E Derchi
Oct 1, 2020·Der Radiologe·Katja Glutig, Hans-Joachim Mentzel
Sep 30, 2020·Abdominal Radiology·Hassan AboughaliaRamesh S Iyer
Nov 15, 2020·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Heather A Martin, Marcy Noble
Oct 30, 2020·Open Access Emergency Medicine : OAEM·Abdullah LaherAhmed Adam
Mar 5, 2021·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
Apr 28, 2020·Emergency Medicine Clinics of North America·B Lorrie Edwards, David Dorfman
Mar 11, 2021·Urology·J Patrick BrooksTora Seals
Apr 23, 2021·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Akshya GuptaVikram Dogra
Dec 16, 2020·Journal of Pediatric Urology·Milan GopalHaitham Dagash
Jul 10, 2021·Journal of Clinical Ultrasound : JCU·Takahiro HosokawaEiji Oguma
Aug 10, 2021·Scandinavian Journal of Urology·Karl Teurneau-HermanssonMagnus Wagenius

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