Version May 2024
| Testicular torsion | Torsion of appendage | Acute epididymitis | |
| Historical features | |||
| Peak incidence | Perinatal and puberty | Prepubertal | <2 years and postpubertal |
| Onset of pain | Usually sudden | Usually sudden | Usually gradual |
| Duration of pain | Usually <12 hours | Usually >12 hours | Usually >24 hours |
| Previous episodes | Typical | Unusual | If previous episode |
| Nausea and vomiting | Common | Uncommon | Uncommon |
| Fever | Unusual | Unusual | Common |
| History of trauma | Occasional | Unusual | Unusual |
| Dysuria or discharge | Rare | Rare | Common |
| Physical findings | |||
| Suggestive findings | Horizontal lie, high-riding testicle | Palpable nodule "blue dot" | None |
| Cremasteric reflex | Usually absent | Usually present | Usually present |
| Tenderness | Testicular initially, then diffuse | Appendage initially, then testis | Epididymis initially, then diffuse |
| Scrotal erythema or edema | Common >12 hours | Common >12 hours | Common >12 hours |
| Laboratory tests | |||
| Pyuria | Unusual | Unusual | Common |
| Positive smear, culture, rapid molecular testing, or NAAT for STD | No | No | Often |
| Leukocytosis | Common | Uncommon | Common |
| Imaging | |||
| Color Doppler ultrasound¶ | Decreased blood flow, spermatic cord knot | Normal or increased | Normal or increased |
* In some boys with scrotal pain, significant overlap in history, physical examination, and diagnostic studies exist. When testicular torsion cannot be excluded, surgical consultation is advised.
¶ Color Doppler ultrasound should be obtained as an emergency study in patients with findings of testicular torsion.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
