Ultrasonography in testicular torsion

Testicular torsion was evaluated by B-scan ultrasound in one experimental animal and in 12 patients. The clinical findings were categorized as acute, subacute, or chronic depending on the amount of time that had elapsed since the onset of pain (less than 24 hours, 1 to 10 days, and more than 10 days, respectively). A consistent pattern of sonographic parenchymal changes for each of these stages is described. The ultrasound textural changes were found to be diagnostically useful when correlated with the clinical findings. Scrotal ultrasound also complements radioisotope studies, locating the testicle when it cannot be found by palpation, and may detect testicular torsion that is not suspected clinically. When physiologic blood flow studies are normal in the clinical setting of possible torsion, ultrasound is more accurate than other imaging modalities in demonstrating pathology.