Ultrasonographic diagnosis of testicular torsion by emergency physicians

Testicular torsion has an incidence of one case per 4,000 men/boys. Most fr equently affected are pubescent boys. Average testicular salvage rate is on ly 50%, and infertility can result. Testicular torsion remains problematic for emergency physicians (EPs) as clinical diagnosis can be difficult and o ther testicular pathology can present similarly. In many institutions there are delays in obtaining Doppler or Scintigraphy studies during off hours. We report two cases of testicular torsion diagnosed by the treating EPs usi ng power Doppler in the emergency department (ED). Rapid diagnosis of torsi on led to successful salvage of the affected testicle in both cases. These represent the first cases for emergency screening ultrasound examinations ( ESUEs) of testicular torsion in the literature. Rapid technological advance s over the last decade have brought portable equipment with high-resolution capability to the bed side for EPs, who should consider using it more freq uently to evaluate testicular torsion. (Am J Emerg Med 2000;18:198-200. Cop yright (C) 2000 by W.B. Saunders Company).