II. Indications
- Suspected Testicular Torsion for patients age >10 years old
III. Criteria
- Score 2: Testicular Swelling
- Score 2: Hard Testicle (firm compared with opposite side)
- Score 1: Cremasteric Reflex Absent
- Score 1: Nausea or Vomiting
- Score 1: High Riding Testicle
IV. Interpretation: Based on Sum of scores from 5 criteria above
- Total Score >5
- Emergent Urologic Consultation
- Total Score 2 to 5
- Testicular Ultrasound with flow
- Total Score <2 (some studies include a score of 2 as low risk)
- Testicular Torsion unlikely
V. Efficacy
- Study of teens under age 18 years (scoring risk stratification varies from above protocol)
- Low risk group (0-2): 2.2% had Testicular Torsion
- Medium risk group (3-4): 22.3% had Testicular Torsion
- High risk group (5-7): 86.7% had Testicular Torsion
- Qin (2022) J Urol 208(1): 62-70 [PubMed]