Torsion of the Appendices and Epididymis Guidelines

Updated: Oct 20, 2016
  • Author: Jason S Chang, MD; Chief Editor: Erik D Schraga, MD  more...
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Guidelines Summary

The following guidelines have been published by the American College of Radiology [12] :

  • Patients with a strong clinical suspicion for testicular torsion may be promptly referred for scrotal exploration.

  • Color Doppler ultrasonography (CDU) with grayscale imaging and special attention to the spermatic cord is the study of choice to evaluate patients with acute scrotal pain, because of its widespread availability and its ability to diagnose testicular torsion with a high degree of sensitivity and specificity, as well as to distinguish other causes of scrotal pain and swelling.

  • Radionuclide scrotal imaging (RNSI) is infrequently used because of longer examination times, less availability, use of radiation, and diminished diagnostic capability in young boys.

  • If CDU is performed and the results are equivocal for testicular torsion, scrotal exploration may be undertaken.

  • Studies are needed to help determine the role of MRI in patients who have acute scrotal pain but equivocal CDU findings.