What can be mistaken for testicular torsion?

Conditions that may mimic testicular torsion, such as torsion of a testicular appendage, epididymitis, trauma, hernia, hydrocele, varicocele and Schönlein-Henoch purpura, generally do not require immediate surgical intervention.
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Is it testicular torsion or something else?

Signs and symptoms of testicular torsion include: Sudden, severe pain in the scrotum — the loose bag of skin under your penis that contains the testicles. Swelling of the scrotum. Abdominal pain.
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Can testicular torsion be misdiagnosed?

Testicular torsion is a rare but painful condition that is often misdiagnosed by medical professionals. If left untreated, the torsion may worsen until the patient's testicle must be surgically removed. Minority children are particularly likely to suffer delayed diagnoses, leading to permanent, irreparable harm.
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How can you tell the difference between testicular torsion and epididymitis?

Prehn's sign is a clinical finding that helps clinicians determine whether testicular pain is caused by epididymitis or testicular torsion. A positive Prehn's sign, characterized by pain relief from the maneuver, is indicative of epididymitis, or the inflammation of the epididymis (a duct running behind the testes).
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How often is testicular torsion misdiagnosed?

Results: The error rate of initial diagnosis was 84.3%, among which 81 cases (71.7%) were misdiagnosed as acute epididymitis or testis, 10 (8.8%) as hydrocele of the tunica vaginalis, and 7 (6.2%) as acute enteritis.
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Testicular torsion: causes, symptoms, diagnosis and treatment - Clinical Anatomy | Kenhub



How do you rule out torsion?

Doctors often diagnose testicular torsion with a physical exam of the scrotum, testicles, abdomen and groin. Your doctor might also test your reflexes by lightly rubbing or pinching the inside of your thigh on the affected side. Normally, this causes the testicle to contract.
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Can an ultrasound Miss testicular torsion?

“If you are still concerned after a normal ultrasound, consult urology.” A negative ultrasound decreases the likelihood of testicular torsion, says Couperus, “but errors in radiology reads and intermittent torsion can still occur.”
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Is there mild testicular torsion?

Intermittent testicular torsion (ITT) is another important clinical condition that may be misdiagnosed even in a pediatric population [4]. Testicular torsion in adults is less common, and ITT in adults is even less reported and may not be considered in the differential diagnosis of acute testicular pain [7].
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Does testicular torsion hurt to the touch?

You will definitely feel pain if your testicles are struck or kicked. You might also feel nauseated for a short time. If the testicular injury is minor, the pain should gradually subside in less than an hour, and any other symptoms should go away as well.
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Can testicular torsion have mild pain?

With torsion of a testicular appendage, the onset of testicle pain may be sudden or gradual, and the severity of pain may range from mild to severe. Generally, a person has no symptoms or signs like nausea, vomiting, and fever.
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Can epididymitis be misdiagnosed?

Epididymitis is the most frequent misdiagnosis in cases of testicular torsion. The delay caused by the misdiagnosis can result in testicular loss. It is important to differentiate the conditions, and if unclear, obtain an imaging study.
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What is idiopathic testicular pain?

CSCP , also referred to as chronic orchialgia or testicular pain syndrome, is persistent pain (lasting at least three months) that is localized to the testicle, epididymis and spermatic cord and interferes with a patient's quality of life.
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Is testicular torsion pain constant?

What Are the Symptoms of Testicular Torsion? If you have a testicular torsion, chances are you'll know it. You'll feel a sudden, possibly severe pain in your scrotum and one of your testicles. The pain might increase and decrease but generally won't go away completely.
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Can you have testicular torsion without swelling?

Early on, there may not be swelling. But very shortly after, the scrotal skin will swell and turn red. You may also feel nauseous and vomit. Testicular torsion is a medical emergency.
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Is testicular torsion unbearable?

If your son has testicular torsion, he'll feel a sudden, possibly severe pain in his scrotum and one of his testicles. The pain can get worse or ease a bit, but probably won't go away completely. If your son has sudden groin pain, get him to a hospital emergency room as soon as you can.
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What is partial testicular torsion?

Intermittent torsion is defined as sudden onset of unilateral testicular pain of short duration with spontaneous resolution. In partial or incomplete torsion, the degree of spermatic cord twist is less than 360°, allowing for some residual perfusion to the testis. However there is no spontaneous resolution of pain [1].
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Can you have testicular torsion for weeks?

Testicular torsion is an important and common cause of acute testicular pain and can occur intermittently even for many years in some patients.
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Can a testicle twist without pain?

The largest retrospective study on this subject found a 10.7% incidence of solitary abdominal pain without scrotal pain in 84 patients with confirmed testicular torsion.
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How accurate is ultrasound for detecting testicular torsion?

The sensitivity of color Doppler examination with newer ultrasonography equipment in detecting acute testicular torsion in children is 90-100%, with the specificity of technically adequate studies being essentially 100%.
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How accurate is testicular ultrasound?

Conclusions: Testis US of malignant lesions underestimates the size in 25% of the cases, a fact that may impact on the decision of testicular sparing surgery. The ultrasonic lesions were eventually proven to be benign in 16% of the cases.
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Can you see testicular torsion on CT?

Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis.
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Can testicular torsion fix itself?

Sometimes, testicular torsion can cause a sudden pain in the testicle that goes away without treatment. This is because the testicle twists and then untwists on its own. If this happens, see a doctor as soon as possible. You might be advised that surgery is needed to prevent it happening again.
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Can sitting down too much cause testicular pain?

Sexual activity can aggravate the pain. CTP may also worsen when sitting for long periods of time, such as at a desk job or driving a truck. Doing heavy lifting, manual work, or even swinging a golf club may trigger CTP in a person who is prone to it.
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Should I see a urologist for testicular pain?

Testicular pain, lump or masses: When testicular pain is persistent and does not go away within two weeks, it is time to see a Urologist. Any masses, firmness or nodules on the testicles should be examined by a urologic specialist, due to the chance of testicular cancer.
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Can pinched nerve cause pain in testicle?

There may also be referred pain to the testis, which means there is pain that originates elsewhere, but is felt in the testis. This can occur if there is a pinched nerve in the back or in the groin area.
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