To illustrate the role of high resolution and color Doppler sonography in the differential diagnosis of acute scrotum in children outlining the advantages of this technique in the diagnosis of incomplete testicular torsion
Testicular torsion ( Fig.
1 ) is a pediatric emergency requires a timely diagnosis to prevent ischemic damage ( Fig 2 ). The color-flow Doppler is considered the gold-standard in the diagnosis of acute scrotum. We describe 4 cases of testicular torsion of the testis with a preserved vascular sign,
diagnosed by the evidence of the whirlpool sign.
Imaging findings OR Procedure details
Four children (ages 3-6 years old),
come to our attention for testicular pain (3 right and 1 left) with slight hyperemia of the scrotal skin and pain in the lower quadrants of the abdomen.
Gray scale and color Doppler sonography of the scrotum was performed with a 12 to 15 MHz transducer (Aloka 5000prosound,
CT). During the examination we assessed ( Fig.
1 ): testis epididymis scrotal wall spermatic cord The spermatic cord was carefully explored when it was present...
In the acute scrotum,
ultrasonography should include the study of the spermatic cord,
especially in patients whose the ecocolor-Doppler show the flow signals in the testis. The whirlpool sign is particularly useful in the diagnosis of incomplete torsion. Grazie
Prando D (2009) Torsion of the spermatic cord : the main gray-scale and Doppler sonographic signs.
Abdom Imaging 34:648-661. Boopathy Vijayaraghavan S (2006) Sonoraphic differential diagnosis of acute scrotum.
Real-time Whirlpool sign,
a key sign of torsion.
J Ultrasound Med 25: 563-574. Callewaert PRH,
Van Kerrebroeck (2010) New insights into perinatal testicular torsion,
Eur J Pediatric 169; 705-712.