Core EM - Emergency Medicine Podcast

Episode 143.0 – Testicular Torsion

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This week we review the presentation, examination and diagnosis of testicular torsion.

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Tags: Acute Scrotal Pain, Torsion, Urology
Show Notes

Take Home Points

  • Consider the diagnosis of testicular torsion in all patients with acute testicular pain
  • Testicular torsion is a surgical emergency that requires immediate urologic consultation to increase the rate of tissue salvage.
  • History, physical examination and ultrasound are all flawed in making the diagnosis. The gold standard is surgical exploration
  • Consider manual detorsion in patients where consultation will be delayed

    • Show Notes

    Core EM: Testicular Torsion

    Ben-Israel T et al. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med 2010; 28:786-789.

    Sidler D et al. A 25-year review of the acute scrotum in children. S Afr Med J. 1997;87(12) 1696-8. PMID:

    Mellick LB. Torsion of the testicle: It is time to stopping tossing the dice. Pediatric Emer Care 2012; 28: 80-6. PMID:

    Ban KM, Easter JS: Selected Urologic Problems; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 99: p 1326-1356.


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