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Testicular torsion in children
Canadian Family Physician Medecin De Famille Canadien
|September 15, 2021
Summary
The Testicular Workup for Ischemia and Suspected Torsion (TWIST) score helps identify children at risk for testicular torsion. A low TWIST score may avoid urgent referral, while a higher score necessitates immediate management.
Area of Science:
- Pediatric emergency medicine
- Urology
- Clinical decision support
Background:
- Testicular pain in children requires prompt evaluation due to the risk of testicular torsion.
- Delayed diagnosis and treatment of testicular torsion can lead to severe complications, including testicular loss.
Purpose of the Study:
- To outline best practices for the assessment and management of testicular pain in pediatric patients.
- To introduce the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score as a tool for risk stratification.
Main Methods:
- The abstract describes the application of the validated Testicular Workup for Ischemia and Suspected Torsion (TWIST) score.
- Clinical suspicion and TWIST score are used to guide management decisions in pediatric patients presenting with testicular pain.
Main Results:
- A TWIST score of 0, with low clinical suspicion in an office setting, does not require an urgent urology referral.
- A TWIST score of 1 or higher, or clinical suspicion of torsion, warrants immediate manual detorsion and emergency department referral.
Conclusions:
- The TWIST score provides a validated method to aid clinicians in assessing the risk of testicular torsion in children.
- Appropriate application of the TWIST score can help differentiate between cases requiring urgent intervention and those that may not.
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