Abstract
Article: Partial Testicular Torsion and Torsion-Detorsion Syndrome
Authors: Nayana U. Patel, MD, Julia A. Drose, BA, RDMS, RDCS, RVT, and Paul Russ, MD
Category: Abdomen/Small Parts
Credit: 1.0 SDMS CME Credit
Objectives: After studying the article entitled “Partial Testicular Torsion and Torsion-Detorsion Syndrome,” you will be able to:
Differentiate testicular torsion from epididymo-orchitis using duplex ultrasound
Describe the hemodynamic changes associated with prolonged testicular torsion
Quantify spectral Doppler changes seen in testicular torsion
Because of similar signs and symptoms, clinical differentiation of testicular torsion and epididymo-orchitis may be difficult in approximately what percentage of cases? 40% 50% 60% 70%
In the male population younger than 25 years, the annual incidence of testicular torsion is approximately one in 4000 5000 6000 7000
Treatment of testicular torsion is typically Careful observation Pain medication The Prehn maneuver Surgery
The optimal window for definitive treatment of testicular torsion from the time of onset of symptoms is less than 6 hours 12 hours 18 hours 24 hours
Gray-scale sonographic findings in testicular torsion may include all of the following except Normal early phase echogenicity Hyperechogenicity secondary to 4 to 6 hours of ischemia Heterogeneous echogenicity secondary to infarction after 24 hours A reactive hydrocele
The average normal resistive index in the intratesticular arteries is approximately 0.45 0.52 0.62 0.78
The initial hemodynamic change associated with testicular torsion is Arterial narrowing with decreased flow Arteriolar constriction elevating vascular resistance Arterial occlusion causing ischemia Venous obstruction
Characteristic color and spectral Doppler changes associated with testicular torsion include all of the following except Overall decreased flow in the affected testis Decreased diastolic flow on spectral Doppler An exaggerated dicrotic notch in the spectral Doppler waveform An increase in the arterial resistive index
Spread of infection of epididymitis will lead to orchitis in approximately what percentage of cases? 10%–20% 20%–40% 40%–60% 60%–70%
Except in cases of very severe epididymo-orchitis, the distinguishing hemodynamic characteristic of epididymo-orchitis that differentiates it from testicular torsion is Decreased diastolic flow on spectral Doppler A multiphasic flow signal typical of peripheral arteries Hyperemic, low-resistance flow in the testis A to-and-fro flow pattern
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