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Twist Score

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Twist Score

  • See Also
  1. Testicular Torsion
  • Indications
  1. Suspected Testicular Torsion for patients age >10 years old
  • Criteria
  1. Score 2: Testicular Swelling
  2. Score 2: Hard Testicle (firm compared with opposite side)
  3. Score 1: Cremasteric Reflex Absent
  4. Score 1: Nausea or Vomiting
  5. Score 1: High Riding Testicle
  • Interpretation
  • Based on Sum of scores from 5 criteria above
  1. Total Score >5
    1. Emergent Urologic Consultation
  2. Total Score 2 to 5
    1. Testicular Ultrasound with flow
  3. Total Score <2 (some studies include a score of 2 as low risk)
    1. Testicular Torsion unlikely
  • Efficacy
  1. Study of teens under age 18 years (scoring risk stratification varies from above protocol)
    1. Low risk group (0-2): 2.2% had Testicular Torsion
    2. Medium risk group (3-4): 22.3% had Testicular Torsion
    3. High risk group (5-7): 86.7% had Testicular Torsion
    4. Qin (2022) J Urol 208(1): 62-70 [PubMed]
  • References
  1. Frolich (2017) Acad Emerg Med 24(12):1474-82 +PMID:28833896 [PubMed]
  2. Sheth (2016) J Urol 195(6):1870-6 +PMID:26835833 [PubMed]