Testicular torsion: twists and turns

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Testicular torsion is a common cause of acute scrotal pain, requiring prompt diagnosis.
• Understanding normal testicular anatomy and vascularity is crucial for identifying torsion.
• Various clinical and sonographic findings are associated with testicular torsion.

Purpose of the Study:

• To review the clinical and sonographic findings of intravaginal and extravaginal testicular torsion.
• To emphasize the role of Doppler ultrasound in diagnosing different types of testicular torsion.
• To present sonographic features of testicular torsion mimics and new imaging developments.

Main Methods:

• Review of clinical presentations and sonographic findings in testicular torsion.
• Detailed description of normal testicular sonographic and vascular anatomy.
• Emphasis on color flow Doppler and spectral Doppler in diagnosing torsion.
• Presentation of sonographic features of mimics like vasculitis and venous thrombosis.
• Inclusion of new imaging modalities such as contrast-enhanced ultrasound and MRI.

Main Results:

• Intravaginal and extravaginal testicular torsion present with distinct clinical and sonographic features.
• Doppler ultrasound is essential for evaluating testicular perfusion and diagnosing complete, incomplete, and intermittent torsion.
• Sonography can differentiate testicular torsion from mimics, aiding in appropriate management.
• Emerging imaging techniques offer potential advancements in diagnosing testicular torsion.

Conclusions:

• Accurate diagnosis of testicular torsion relies on integrating clinical findings with comprehensive sonographic evaluation.
• Doppler ultrasound plays a pivotal role in the timely and accurate diagnosis of testicular torsion.
• Advanced imaging techniques show promise for improving the diagnostic accuracy and management of testicular torsion.