Document Detail

Duplex sonographic findings in children with torsion of the testicular appendages: overlap with epididymitis and epididymoorchitis.
MedLine Citation:
PMID:  16516624     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Torsion of the testicular appendages (TTA) is the most common cause of acute scrotum in children, and yet there are only few dedicated studies of the imaging findings. OBJECTIVE: To review our experience with the use of duplex sonography in children with TTA and to evaluate if sonography can successfully distinguish TTA from epididymoorchitis. METHODS: We reviewed the medical files and imaging findings of 29 children aged 0.7 to 13.9 years (mean, 6.5 years) with a diagnosis of TTA based on testicular exploration who were evaluated preoperatively with duplex sonography. RESULTS: A tender upper pole nodule, the typical sign of TTA, was palpated in only 2 (6.9%) children. Duplex sonography demonstrated an extratesticular upper pole nodule in 9 (31%) children. Secondary inflammatory changes included hydrocele in 22 (75.9%), enlarged epididymis in 22 (75.9%), scrotal wall edema in 16 (55.2%), and swollen testis in 9 (31%) children. Fourteen (48%) children had inflammatory changes with no evidence of an extratesticular nodule. CONCLUSION: Duplex sonography findings of secondary inflammatory changes in the absence of evidence of an extratesticular nodule may suggest an erroneous diagnosis of epididymitis or epididymoorchitis in children with TTA.
Boaz Karmazyn; Ran Steinberg; Pinchas Livne; Liora Kornreich; Sylvia Grozovski; Michael Schwarz; Nitza Ziv; Enrique Freud
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  41     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-06     Completed Date:  2006-08-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  500-4     Citation Subset:  IM    
Department of Imaging, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 49202, Israel.
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MeSH Terms
Acute Disease
Child, Preschool
Diagnosis, Differential
Diagnostic Errors
Epididymitis / ultrasonography*
Pain / etiology
Retrospective Studies
Scrotum / pathology,  ultrasonography
Testicular Diseases / ultrasonography*
Torsion Abnormality / ultrasonography
Ultrasonography, Doppler, Duplex

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