title: Gray-scale sonography in torsion of the testicular appendages.
abstract: The reliability of gray-scale ultrasonography in diagnosing torsion of the testicular appendages was studied in a series of 54 boys with acute non-traumatic scrotal pain. All boys were operated upon, and the appendages extirpated irrespective of their appearance at exploration; the final diagnosis was based on histological examination. Forty-two boys had appendicular torsion, 2 had testicular torsion and 10 had other diagnoses. Using the sign of appendicular torsion--an echogenic extratesticular structure situated between the head of the epididymis and the upper pole of the testis--as the criterion, 37 displayed a true positive, 9 a true negative, 3 a false positive and 5 a false negative diagnosis. Thus, the sensitivity was 88%, the specificity 75% and the positive predictive value 93% respectively. The echogenic mass varied in size from 3 to 17 mm in diameter. In 34 of the 42 cases of appendicular torsion extratesticular fluid was present, and 19 patients showed enlargement of the head of the epididymis. It is concluded that gray-scale sonography is an accurate and valuable tool in diagnosing torsion of the testicular appendages.
authors.affiliation: Department of Pediatric Radiology, St. Göran Children's Hospital, Stockholm, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Hesser
authors.forename: M
authors.initials: M
authors.lastname: Rosenborg
authors.forename: J
authors.initials: J
authors.lastname: Gierup
authors.forename: B
authors.initials: B
authors.lastname: Karpe
authors.forename: A
authors.initials: A
authors.lastname: Nyström
authors.forename: L
authors.initials: L
authors.lastname: Hedenborg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004822:Epididymis / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging*; D013737:Testis / Q000000981:diagnostic imaging; D014463:Ultrasonography