Colour Doppler ultrasonography replacing surgical exploration for acute scrotum: myth or reality?

Surgical management of testicular torsion

“…Other studies have also shown similarly high sensitivity (95.7-100%) and specificity (85.3-100%) for CDS in diagnosing testicular torsion. [26][27][28] However, CDS can be inaccurate and false-negatives can occur, especially in cases of early TT, intermittent torsion or incomplete torsion of the spermatic cord. Several studies have demonstrated arterial flow in affected testes, which were subsequently shown to be torted at surgery.…”

Neonatal adrenal hemorrhage mimicking an acute scrotum

“…16 In the diagnosis of testicular torsion, ultrasound has been reported to have a specificity of 100%, a sensitivity of 69.2%, a positive predictive value of 100% and a negative predictive value of 97.5%. Lam et al 17 reported an incidence of 1.2% false-negative Doppler flow studies in patients presenting with clinical signs of torsion.…”

“…An extratesticular signal in these cases may appear intratesicular. 17 The technical key is to optimize color Doppler settings to detect low flow and to be certain that intratesticular flow is detected and not the flow within extracapsular vessels, epididymis or surrounding structures. 18 In our case, sonographic evaluation of the scrotum revealed an edematous scrotum with marked thickening of the subcutaneous tissue and a fluid collection inside without double ring hemorrhage image.…”

Common urological problems in children: inguinoscrotal pathologies

“…Normal intra-testicular perfusion does not exclude the possibility of torsion and there remains a falsenegative rate in this modality. 51,52 As a missed diagnosis of testicular torsion is one of the most common medicolegal claims in adolescent patients in the United States, 53 we must stress again the prime importance of clinical evaluation and decision. Nuclear scintigraphy and MRI are not popular for the same reason.…”