Gray-scale sonography in torsion of the testicular appendages


The reliability of gray-scale ultrasonography in diagnosing torsion of the testicular appendages was studied in a series of 54 boys with acute non-traumatic scrotal pain. All boys were operated upon, and the appendages extirpated irrespective of their appearance at exploration; the final diagnosis was based on histological examination. Forty-two boys had appendicular torsion, 2 had testicular torsion and 10 had other diagnoses. Using the sign of appendicular torsion — an echogenic extratesticular structure situated between the head of the epididymis and the upper pole of the testis — as the criterion, 37 displayed a true positive, 9 a true negative, 3 a false positive and 5 a false negative diagnosis. Thus, the sensitivity was 88%, the specificity 75% and the positive predictive value 93% respectively. The echogenic mass varied in size from 3 to 17 mm in diameter. In 34 of the 42 cases of appendicular torsion extratesticular fluid was present, and 19 patients showed enlargement of the head of the epididymis. It is concluded that gray-scale sonography is an accurate and valuable tool in diagnosing torsion of the testicular appendages.

DOI: 10.1007/BF02012140

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@article{Hesser1993GrayscaleSI, title={Gray-scale sonography in torsion of the testicular appendages}, author={Ulf Hesser and Magnus Rosenborg and J. Gierup and Bengt Karpe and Alf Nystr{\"{o}m and L. Hedenborg}, journal={Pediatric Radiology}, year={1993}, volume={23}, pages={529-532} }