Term testicular torsion refers to twisting of spermatic cord, which results in infarction of testicular parenchyma due to cessation of blood supply
Apart from spermatic cord torsion, testicular infarction can also result from severe epididymoorchitis, trauma, hematological disorders, such as polycythemia and sickle cell disease, vasculitides, and previous surgery
Torsion of epididymal or testicular appendage refers to torsion of small structure attached to epididymis or testis, representing developmental remnants
PATHOLOGY
General Features
CLINICAL IMPLICATIONS
Presentation
Treatment
IMAGING
General Features
Technical Recommendations
US Findings
CEUS Findings
DIFFERENTIAL DIAGNOSIS
Testicular Ischemia
Selected References
Bandarkar AN et al: Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr Radiol. 48(5):735-744, 2018
Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: Update 2017 (Long Version). Ultraschall Med. 39(2):e2-e44, 2018
Tsili AC et al: MRI of the scrotum: Recommendations of the ESUR Scrotal and Penile Imaging Working Group. Eur Radiol. 28(1):31-43, 2018
Badea R et al: Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay. Med Ultrason. 18(1):110-5, 2016
Rafailidis V et al: Sonography of the scrotum: from appendages to scrotolithiasis. J Ultrasound Med. 34(3):507-18, 2015
Tsili AC et al: MR imaging of scrotum. Magn Reson Imaging Clin N Am. 22(2):217-38, vi, 2014
Yusuf GT et al: A review of ultrasound imaging in scrotal emergencies. J Ultrasound. 16(4):171-8, 2013
Yusuf G et al: Global testicular infarction in the presence of epididymitis: clinical features, appearances on grayscale, color Doppler, and contrast-enhanced sonography, and histologic correlation. J Ultrasound Med. 32(1):175-80, 2013
Bertolotto M et al: Acute segmental testicular infarction at contrast-enhanced ultrasound: early features and changes during follow-up. AJR Am J Roentgenol. 196(4):834-41, 2011
Valentino M et al: Role of contrast enhanced ultrasound in acute scrotal diseases. Eur Radiol. 21(9):1831-40, 2011
Nussbaum Blask AR et al: Sonographic appearance of the epididymis in pediatric testicular torsion. AJR Am J Roentgenol. 187(6):1627-35, 2006
Paltiel HJ et al: Pulse-inversion US imaging of testicular ischemia: quantitative and qualitative analyses in a rabbit model. Radiology. 239(3):718-29, 2006
Vijayaraghavan SB: Sonographic differential diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion. J Ultrasound Med. 25(5):563-74, 2006
Wilbert DM et al: Evaluation of the acute scrotum by color-coded Doppler ultrasonography. J Urol. 149(6):1475-7, 1993
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
TERMINOLOGY
Synonyms
Testicular torsion or spermatic cord torsion
Definitions
Term testicular torsion refers to twisting of spermatic cord, which results in infarction of testicular parenchyma due to cessation of blood supply
Apart from spermatic cord torsion, testicular infarction can also result from severe epididymoorchitis, trauma, hematological disorders, such as polycythemia and sickle cell disease, vasculitides, and previous surgery
Torsion of epididymal or testicular appendage refers to torsion of small structure attached to epididymis or testis, representing developmental remnants
PATHOLOGY
General Features
CLINICAL IMPLICATIONS
Presentation
Treatment
IMAGING
General Features
Technical Recommendations
US Findings
CEUS Findings
DIFFERENTIAL DIAGNOSIS
Testicular Ischemia
Selected References
Bandarkar AN et al: Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr Radiol. 48(5):735-744, 2018
Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: Update 2017 (Long Version). Ultraschall Med. 39(2):e2-e44, 2018
Tsili AC et al: MRI of the scrotum: Recommendations of the ESUR Scrotal and Penile Imaging Working Group. Eur Radiol. 28(1):31-43, 2018
Badea R et al: Contrast enhanced harmonic ultrasonography for the evaluation of acute scrotal pathology. A pictorial essay. Med Ultrason. 18(1):110-5, 2016
Rafailidis V et al: Sonography of the scrotum: from appendages to scrotolithiasis. J Ultrasound Med. 34(3):507-18, 2015
Tsili AC et al: MR imaging of scrotum. Magn Reson Imaging Clin N Am. 22(2):217-38, vi, 2014
Yusuf GT et al: A review of ultrasound imaging in scrotal emergencies. J Ultrasound. 16(4):171-8, 2013
Yusuf G et al: Global testicular infarction in the presence of epididymitis: clinical features, appearances on grayscale, color Doppler, and contrast-enhanced sonography, and histologic correlation. J Ultrasound Med. 32(1):175-80, 2013
Bertolotto M et al: Acute segmental testicular infarction at contrast-enhanced ultrasound: early features and changes during follow-up. AJR Am J Roentgenol. 196(4):834-41, 2011
Valentino M et al: Role of contrast enhanced ultrasound in acute scrotal diseases. Eur Radiol. 21(9):1831-40, 2011
Nussbaum Blask AR et al: Sonographic appearance of the epididymis in pediatric testicular torsion. AJR Am J Roentgenol. 187(6):1627-35, 2006
Paltiel HJ et al: Pulse-inversion US imaging of testicular ischemia: quantitative and qualitative analyses in a rabbit model. Radiology. 239(3):718-29, 2006
Vijayaraghavan SB: Sonographic differential diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion. J Ultrasound Med. 25(5):563-74, 2006
Wilbert DM et al: Evaluation of the acute scrotum by color-coded Doppler ultrasonography. J Urol. 149(6):1475-7, 1993
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