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Testicular Torsion/Infarction
Shweta Bhatt, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Spermatic cord torsion
          • Definitions

            • Spontaneous or traumatic twisting of testis and spermatic cord within scrotum, resulting in vascular occlusion/infarction

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • MR Findings

                • Nuclear Medicine Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Hosokawa T et al: Diagnostic accuracy of ultrasound for the directionality of testicular rotation and the degree of spermatic cord twist in pediatric patients with testicular torsion. J Ultrasound Med. 39(1):119-26, 2020
                                          2. Lorenzo L et al: Bilateral testicular torsion in an adolescent: a case with challenging diagnosis. Int Braz J Urol. 44(2):393-6, 2018
                                          3. Yecies T et al: Direction of rotation in testicular torsion and identification of predictors of testicular salvage. Urology. 114:163-6, 2018
                                          4. Hazeltine M et al: Testicular torsion: current evaluation and management. Urol Nurs. 37(2):61-71, 93, 2017
                                          5. Esposito F et al: The "whirlpool sign", a US finding in partial torsion of the spermatic cord: 4 cases. J Ultrasound. 17(4):313-5, 2014
                                          6. Avery LL et al: Imaging of penile and scrotal emergencies. Radiographics. 33(3):721-40, 2013
                                          7. Yusuf GT et al: A review of ultrasound imaging in scrotal emergencies. J Ultrasound. 16(4):171-8, 2013
                                          8. Sung EK et al: Sonography of the pediatric scrotum: emphasis on the Ts--torsion, trauma, and tumors. AJR Am J Roentgenol. 198(5):996-1003, 2012
                                          9. Yagil Y et al: Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 29(1):11-21, 2010
                                          10. Prando D: Torsion of the spermatic cord: the main gray-scale and Doppler sonographic signs. Abdom Imaging. 34(5):648-61, 2009
                                          11. Bhatt S et al: Role of US in testicular and scrotal trauma. Radiographics. 28(6):1617-29, 2008
                                          12. Pepe P et al: Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 60(1):120-4, 2006
                                          13. Schalamon J et al: Management of acute scrotum in children--the impact of Doppler ultrasound. J Pediatr Surg. 41(8):1377-80, 2006
                                          14. 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
                                          15. Dogra V et al: Acute painful scrotum. Radiol Clin North Am. 42(2):349-63, 2004
                                          16. Dogra VS et al: Torsion and beyond: new twists in spectral Doppler evaluation of the scrotum. J Ultrasound Med. 23(8):1077-85, 2004
                                          17. Dogra VS et al: Sonography of the scrotum. Radiology. 227(1):18-36, 2003
                                          18. Arce JD et al: Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis. Pediatr Radiol. 32(7):485-91, 2002
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Spermatic cord torsion
                                                  • Definitions

                                                    • Spontaneous or traumatic twisting of testis and spermatic cord within scrotum, resulting in vascular occlusion/infarction

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Hosokawa T et al: Diagnostic accuracy of ultrasound for the directionality of testicular rotation and the degree of spermatic cord twist in pediatric patients with testicular torsion. J Ultrasound Med. 39(1):119-26, 2020
                                                                                  2. Lorenzo L et al: Bilateral testicular torsion in an adolescent: a case with challenging diagnosis. Int Braz J Urol. 44(2):393-6, 2018
                                                                                  3. Yecies T et al: Direction of rotation in testicular torsion and identification of predictors of testicular salvage. Urology. 114:163-6, 2018
                                                                                  4. Hazeltine M et al: Testicular torsion: current evaluation and management. Urol Nurs. 37(2):61-71, 93, 2017
                                                                                  5. Esposito F et al: The "whirlpool sign", a US finding in partial torsion of the spermatic cord: 4 cases. J Ultrasound. 17(4):313-5, 2014
                                                                                  6. Avery LL et al: Imaging of penile and scrotal emergencies. Radiographics. 33(3):721-40, 2013
                                                                                  7. Yusuf GT et al: A review of ultrasound imaging in scrotal emergencies. J Ultrasound. 16(4):171-8, 2013
                                                                                  8. Sung EK et al: Sonography of the pediatric scrotum: emphasis on the Ts--torsion, trauma, and tumors. AJR Am J Roentgenol. 198(5):996-1003, 2012
                                                                                  9. Yagil Y et al: Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 29(1):11-21, 2010
                                                                                  10. Prando D: Torsion of the spermatic cord: the main gray-scale and Doppler sonographic signs. Abdom Imaging. 34(5):648-61, 2009
                                                                                  11. Bhatt S et al: Role of US in testicular and scrotal trauma. Radiographics. 28(6):1617-29, 2008
                                                                                  12. Pepe P et al: Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 60(1):120-4, 2006
                                                                                  13. Schalamon J et al: Management of acute scrotum in children--the impact of Doppler ultrasound. J Pediatr Surg. 41(8):1377-80, 2006
                                                                                  14. 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
                                                                                  15. Dogra V et al: Acute painful scrotum. Radiol Clin North Am. 42(2):349-63, 2004
                                                                                  16. Dogra VS et al: Torsion and beyond: new twists in spectral Doppler evaluation of the scrotum. J Ultrasound Med. 23(8):1077-85, 2004
                                                                                  17. Dogra VS et al: Sonography of the scrotum. Radiology. 227(1):18-36, 2003
                                                                                  18. Arce JD et al: Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis. Pediatr Radiol. 32(7):485-91, 2002