Fact-sheet: Testicular torsion
Updated on 09/17/2021 at 12:16 PM
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Definition
Rotation of variable degree of the testis along its longitudinal axis.
Clinical features
Lateralized, intense, sudden-onset scrotal pain, rapidly associated with swelling of the corresponding hemiscrotum.
No fever or urinary symptoms.
Edematous, erythematous hemiscrotum with a horizontally oriented testis.
Ultrasound
In the acute phase: normal sonographic appearance.
Rapidly, there is an increase in volume, and the echostructure then becomes heterogeneous.
When complete, torsion manifests on color Doppler as a total absence of vascularity, contrasting with the contralateral side.
In the delayed phase (beyond 24 hours), after several days of evolution, heterogeneous areas appear, related to hemorrhagic necrosis, often associated with echogenic fluid within the tunica vaginalis corresponding to a hematocele.
On color Doppler, there is peritesticular hypervascularity of the scrotal coverings and epididymis, the latter being related to the opening of anastomoses between the cremasteric and epididymal vessels.