Radiologic Imaging

Imaging tests include: Doppler ultrasonography and nuclear scintigraphy, but their use is still highly controversial, with delays for imaging being termed as ‘castration through procrastination’(14).

Doppler ultrasonography is thought to be useful in equivocal cases with a high sensitivity for confirming increased blood flow seen in epididymitis, but in small children it often detects no blood flow in normal testicles(15).

Nuclear scintigraphy detects the accumulation of IV technetium in the testis. In torsion there is no technetium seen in the testicle. The major downfall of this test is that it takes time (20-30minutes) and isn’t always available.

In the U.K. imaging is only indicated in late presenters with an unclear diagnosis under senior review.

Learning Bite:

Surgical exploration for suspected testicular torsion should NEVER be delayed for imaging.

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