The authors note in their article that prompt diagnosis of testicular torsion is crucial because the risk of losing a testicle increases “substantially after more than 6 hours of symptoms due to the development of testicular ischemia and necrosis.”
Experience is an important factor in diagnosing the acute scrotum, Dr. Sacchetti said by email, noting that less-experienced physicians are more likely to order ultrasound and that any guidelines would have to be “very liberal with use of ultrasound.”
What’s missing from the report are the patient outcomes, he said, such as how many patients were sent home and later found to have testicular torsion, and how many patients were correctly diagnosed with this condition without the use of ultrasound. In short, Dr. Sacchetti concluded, we don’t know whether the high variability in testing was appropriate.
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