PEDIATRICS Vol. 76 No. 6 December 1985, pp. 929-933
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Spermatic Cord Torsion: Diagnostic Limitations

Marshall L. Stoller MD1, Barry A. Kogan MD1, and Hedvig Hricak MD1

1 From the Departments of Urology, Pediatrics, and Radiology, University of California School of Medicine, San Francisco

To distinguish spermatic cord torsion from other intrascrotal pathology, scrotal ultrasound and radionuclide scanning have been highly recommended on the basis of both clinical and experimental studies. We review the data from six patients in whom ultrasound or nuclear medicine examination was misleading. We emphasize that history, physical examination, and urinalysis remain the cornerstones of the diagnosis of spermatic cord torsion. Scrotal ultrasound and nuclear medicine scans are useful adjuncts and are reassuring when in agreement with the clinical picture. However, they are not 100% sensitive or specific, and a negative study should not prevent emergency operative exploration of a clinically suspicious lesion.

Key Words: spermatic cord torsion • testicular torsion • scrotal ultrasound • scrotal radionuclide scanning

Submitted on December 26, 1984
Accepted on February 22, 1985