title: Clinical predictors for testicular torsion as seen in the pediatric ED.
abstract: OBJECTIVE
  The aim of the study was to identify clinical findings associated with increased likelihood of testicular torsion (TT) in children.
  
  
  METHODS
  This study used a retrospective case series of children with acute scrotum presenting to a pediatric emergency department (ED).
  
  
  RESULTS
  Five hundred twenty-three ED visits were analyzed. Mean patient age was 10 years 9 months. Seventeen (3.25%) patients had TT. Pain duration of less than 24 hours (odds ratio [OR], 6.66; 95% confidence interval [CI], 1.54-33.33), nausea and/or vomiting (OR, 8.87; 95% CI, 2.6-30.1), abnormal cremasteric reflex (OR, 27.77; 95% CI, 7.5-100), abdominal pain (OR, 3.19; 95% CI, 1.15-8.89), and high position of the testis (OR, 58.8; 95% CI, 19.2-166.6) were associated with increased likelihood of torsion.
  
  
  CONCLUSIONS
  Testicular torsion is uncommon among pediatric patients presenting to the ED with acute scrotum. Pain duration of less than 24 hours, nausea or vomiting, high position of the testicle, and abnormal cremasteric reflex are associated with higher likelihood of torsion.
authors.affiliation: Pediatric Emergency Unit, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Zerifin 70300, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Beni-Israel
authors.forename: Michael
authors.initials: M
authors.lastname: Goldman
authors.forename: Shmual
authors.initials: S
authors.lastname: Bar Chaim
authors.forename: Eran
authors.initials: E
authors.lastname: Kozer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D000704:Analysis of Variance; D015984:Causality; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004635:Emergency Medicine / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D009325:Nausea / Q000209:etiology; D010372:Pediatrics / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D015995:Prevalence; D012021:Reflex, Abnormal; D012189:Retrospective Studies; D013086:Spermatic Cord Torsion / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D018709:Statistics, Nonparametric; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014839:Vomiting / Q000209:etiology