Testicular Torsion Tripwires

A tripwire is usually a wire stretched near ground level to ensnare someone or to activate a booby trap or detonate explosives, and some chief complaints come with their own built-in tripwires that should cause emergency physicians to stop dead in their tracks. Acute scrotal pain without a doubt is one of those chief complaints. Torsion of the testicle is not the only cause of acute scrotal pain, but it is the one that emergency physicians cannot afford to miss. Unfortunately, this condition comes with an impressive number of tripwires capable of bringing down even the most experienced clinicians:   • Clinical Overlap: The clinical presentation of testicular torsion overlaps significantly with other more benign causes of acute scrotal pain.• Physical Examination: The physical examination for testicular torsion is not always reliable.• Pain Honeymoon: The pain level associated with testicular torsion waxes and wanes; some patients seem to have a pain honeymoon.• Atypical Presentations: Atypical presentations of testicular torsion are not uncommon.   Clinical Presentation OverlapOther conditions such as epididymitis or torsion of the appendix can mimic testicular torsion and vice versa. It seems that presentations of epididymo-orchitis (EO) or torsion of the appendix (TAT) more commonly mimic testicular torsion (TT), but gradual onset and absence of nausea and vomiting are also reported with testicular torsion. Cass et al reported that 16 percent of their patients...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs