Validation of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score in the Diagnosis of Testicular Torsion in Children With Acute Scrotum.

OBJECTIVE

To validate the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score for the evaluation of children presenting with acute scrotum.

METHODS

This prospective study calculated TWIST score in patients of acute scrotum admitted to a pediatric surgery unit. The scoring system consisted of testicular swelling (2 points), hard testicle (2), absent cremasteric reflex (1), nausea/vomiting (1) and high-riding testis (1). All the patients were examined by a pediatric surgeon.

RESULTS

Among 96 children with acute scrotum, 68 (70.8%) patients had testicular torsion. In the testicular torsion group, the mean (SD) TWIST score was 5.7 (1.2) and in no torsion group, it was 1.46 (0.67). In the testicular torsion group, the number of patients with low, intermediate, and high risk was 0, 13, and 55, respectively and in without testicular torsion these were 21, 7, and 0, respectively.

CONCLUSIONS

TWIST score has high predictive value for testicular torsion, and can be used for clinical diagnosis of testicular torsion.