Imaging Acute Scrotal Pain in Adults: Torsion of the Testis and Appendages

  • Ahmet T. Turgut
  • Vikram S. Dogra
Part of the Medical Radiology book series (MEDRAD)


Torsion of the spermatic cord is a common cause of acute scrotal pain and a delay in intervention may cause irreversible testicular damage. Intravaginal testicular torsion, which is associated either with a long mesorchium or bell-clapper deformity, accounts for most of the cases. Gray-scale US combined with color and pulsed Doppler modes is the method of choice for patients with the clinical presentation of testicular torsion, where the findings depend on the duration of torsion and the degree of twisting of the spermatic cord. The absence of testicular blood flow on color or power Doppler US is considered diagnostic of ischemia. On the other hand, the presence of color or power Doppler flow in a patient with a typical clinical presentation for torsion may be consistent with partial testicular torsion. The main role of ultrasound in the torsion of testicular appendix is to rule out testicular torsion or epididymo-orchitis. Optimization of the color and pulsed Doppler parameters is crucial for increasing the diagnostic yield.


Spermatic Cord Inguinal Canal Testicular Torsion Diastolic Flow Testicular Infarction 
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© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of RadiologyAnkara Training and Research HospitalAnkaraTurkey
  2. 2.Department of Imaging SciencesUniversity of Rochester School of MedicineRochesterUSA

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