Boettcher et al identified factors predictive of testicular torsion in a pediatric male. These can help to identify a patient who may benefit from more aggressive management. The authors are from Hamburg University and University Children’s Hospital in Germany.
Predictors of testicular torsion:
(1) painful scrotum for < 24 hours
(2) nausea and/or vomiting
(3) abnormal cremasteric reflex
(4) high position of the affected testis (due to shortening secondary to the torsion)
Additional clinical findings:
(1) abdominal pain
(2) erythema of the hemiscrotum
(3) swelling of the hemiscrotum
Torsion could be excluded if both of the following were present:
(1) long pain duration (> 24 hours)
(2) absence of swelling
Interpretation:
• The presence of 2 or more of the predictors was 100% specific
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