None listed
Conditions
Brief summary
Testicular torsion, or twisting of the testicle, is a very important diagnosis to make correctly and quickly in order to prevent potential loss of a testicle. In other countries ultrasound is used frequently to make or rule out this diagnosis but in Australia it is not used very often. Doctors instead rely on their history taking and examination skills to make the diagnosis. Several clinical calculators have been developed recently to help assist doctors to make these diagnoses. One calculator that has been shown to be helpful in other countries is the TWIST score (Testicular Workup for Ischemia and Suspected Torsion) but no one has investigated if it is also helpful in Australia. The purpose of this study is to determine if the TWIST score is beneficial in the diagnosis of testicular torsion. It is hypothesised the TWIST score will be more accurate than doctors alone in making the diagnosis.
Interventions
This study will look at the demographics, clinical history, physical examination findings and investigation findings of patients presenting with acute scrotal pain and swelling and determine if the TWIST score can be used to safely diagnose or rule out testicular torsion in an Australian paediatric population where ultrasound is not routinely used. We will also use the data to look at other clinical calculators such as the Boettcher Alert Score and Testicular Torsion score.
Each participant wi
This study will look at the demographics, clinical history, physical examination findings and investigation findings of patients presenting with acute scrotal pain and swelling and determine if the TWIST score can be used to safely diagnose or rule out testicular torsion in an Australian paediatric population where ultrasound is not routinely used. We will also use the data to look at other clinical calculators such as the Boettcher Alert Score and Testicular Torsion score. Each participant will have a clinical history and physical examination (roughly 10 mins each) performed by the emergency department doctor and/or surgical doctor. This will be part of standard care and assessment. Participants will have observations done as per normal routine care (hourly unless indicated more frequently). They will have physical examination performed as determined by the treating medical team with no change from routine care. The TWIST score is made up of testicular swelling, hard testis, absent cremasteric reflex, nausea or vomiting and high riding testis and these aspects will be assessed for and documented. Not all participants will have investigations performed but they may include ultrasound, urine dipstick or STI screen. Results of these investigations will be documented and accessed electronically.
Sponsors
Alexander Wilson
Eligibility
Sex/Gender
Male
Age
3 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
Scrotal and/or testicular pain or scrotal swelling Duration of pain < 7 days
Exclusion criteria
Previous testicular torsion previous scrotal surgery or testicular disease Intellectual impairment or behavioural issues that will not allow an accurate assessment of patient and hence collection of data Age < 3 months or > 18 years Ultrasound confirmed diagnosis of testicular torsion prior to presentation
Outcome results
None listed