Assessing Outcomes of Point-of-Care Ultrasound Use in Testicular Torsion in a Pediatric Emergency Department

Testicular torsion is a surgical emergency in which a timely diagnosis under 6 hours can significantly increase the survivability of the testicle. This study aims to retrospectively analyze cases of testicular torsion to determine whether the use of point-of-care ultrasound (POCUS) expedites care compared with radiology department ultrasound (RADUS). We evaluated POCUS effect on emergency department (ED) workflow, urological consultation time, and time to the operating room (OR).

We conducted a retrospective review of patients diagnosed with testicular torsion between January 2021 and October 2024. Inclusion criteria were patients confirmed to have testicular torsion intraoperatively. Demographics were taken of each patient as well as multiple time intervals of events such as radiologic imaging, consult time, and time to surgery. Patients were grouped into 3 cohorts, POCUS only, POCUS followed by RADUS, and RADUS only. Mann-Whitney U tests were performed for pairwise comparisons between groups.

Sixty-five patients were eligible for the study. The time between physician initial assessment (PIA) to the OR in the subgroups of POCUS only, POCUS/RADUS, and RADUS only were 97, 141, and 195 minutes, respectively. A 98-minute difference in the PIA to OR time between POCUS-only and RADUS-only groups (P < 0.001) was found to be statistically significant.

With a difference in PIA to OR time of close to 100 minutes between POCUS-only and RADUS-only groups, our findings suggest that POCUS significantly reduces time to urological consultation and has the potential to expedite surgical intervention if POCUS can reliably replace RADUS. These results highlight the value of integrating POCUS into ED workflows for testicular torsion.