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. 2010 Sep;28(7):786-9.
doi: 10.1016/j.ajem.2009.03.025. Epub 2010 Feb 25.

Clinical predictors for testicular torsion as seen in the pediatric ED

Tali Beni-Israel  1 , Michael Goldman, Shmual Bar Chaim, Eran Kozer
Affiliations

Clinical predictors for testicular torsion as seen in the pediatric ED

Tali Beni-Israel et al. Am J Emerg Med. 2010 Sep.

Abstract

Objective: The aim of the study was to identify clinical findings associated with increased likelihood of testicular torsion (TT) in children.

Design: This study used a retrospective case series of children with acute scrotum presenting to a pediatric emergency department (ED).

Results: Five hundred twenty-three ED visits were analyzed. Mean patient age was 10 years 9 months. Seventeen (3.25%) patients had TT. Pain duration of less than 24 hours (odds ratio [OR], 6.66; 95% confidence interval [CI], 1.54-33.33), nausea and/or vomiting (OR, 8.87; 95% CI, 2.6-30.1), abnormal cremasteric reflex (OR, 27.77; 95% CI, 7.5-100), abdominal pain (OR, 3.19; 95% CI, 1.15-8.89), and high position of the testis (OR, 58.8; 95% CI, 19.2-166.6) were associated with increased likelihood of torsion.

Conclusions: Testicular torsion is uncommon among pediatric patients presenting to the ED with acute scrotum. Pain duration of less than 24 hours, nausea or vomiting, high position of the testicle, and abnormal cremasteric reflex are associated with higher likelihood of torsion.

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