Discuss the common presentation of testicular torsion and overlap with other more common pathologies. Understand the types of torsion and pathophysiology of testicular torsion. Describe the imaging signs associated with testicular torsion and their associated specificity and sensitivity.
Testicular torsion occurs when testis torts on the spermatic cord resulting in loss of blood supply to the testis.
Prompt recognition and treatment is necessary for testicular salvage. Testicular torsion is a rare condition occuring in 1 in 4000 men.
Testicular torsion typically presents with acute unilateral scrotal pain +/- systemic symptoms and is classically diagnosed clinically.
However it can often be difficult to differentiate between testicular torsion and epididymo-orchitis due...
Findings and procedure details
Common presentation of Testicular Torsion •Acute pain - Can be intermittent due to detorsion phenomenom - Not relieved by elevation •Swelling •Vomiting On exam: •Enlargement and oedema of affected testis •Absence of cresmasteric reflex •Abnormal lie of testis - Transverse lie - Anterior rotation However presentation and exam is similar to epididymo-orchitis without fever or urethral discharge which can make clinical diagnosis challenging. Majority of torsions occur spontaneously with only...
Testicular torsion remains a difficult clinical and radiological diagnosis due to overlap of signs and symptoms with more common presentations such as epididymo-orchitis. However,
careful assessment of testis and vasculature,
including the spermatic cord can aid diagnosis especially in equivocal cases. However,
there still remains no definite ultrasound sign of testicular torsion and clinical assessment remains paramount.
Elisabeth O'Dwyer, 4th year resident Department of Radiology Tallaght University Hospital,
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