Barbosa et al reported the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score for evaluating pediatric patients with acute scrotum for testicular torsion. The authors are from Boston Children's Hospital and the University of Sao Paulo.
Patient selection: pediatric male with acute scrotum
Parameters:
(1) testicular swelling
(2) consistency
(3) cremasteric reflex
(4) nausea and/or vomiting
(5) high riding testis
Parameter
Finding
Points
testicular swelling
no
0
yes
2
consistency
hard
2
not hard
0
cremasteric reflex
absent
1
present
0
nausea and/or vomiting
absent
0
present
1
high riding testis
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Score
Risk Group (Barbosa)
0 to 2
low
3 or 4
intermediate
5 to 7
high
Score
Risk Group (Sheth)
0
low
1 to 5
intermediate
6 or 7
high
Performance:
• The performance may be affected by user specialty and training.
• The original study reported an area under the curve of 0.98 while others found 0.82.
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