EM Cases · Testicular torsion
Testicular torsion — time-critical acute scrotum station
ACEM Fellowship OSCE clinical-management station testing torsion recognition, TWIST high-risk pathway, refusal to delay for imaging, and bilateral orchiopexy plan.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A pubertal boy with sudden scrotal pain whose ultrasound is being 'organised' while theatre time slips away.
Station brief
Format. Clinical-management station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant.
Candidate instructions. Manage from the handover. State actions and reasoning aloud. Examiner plays nursing/radiology staff.[6]
References5ShowHide
- [6]Barbosa JA, Tiseo BC, Barayan GA, et al. Development and initial validation of a scoring system to diagnose testicular torsion in children. Journal of Urology, 2013.PMID 23103800
- [4]Ribeiro S, et al. Lessons learned after 10 years of manual detorsion in testicular torsion. Journal of Pediatric Urology, 2026.PMID 41412855
- [14]Ramachandra P, et al. Factors influencing rate of testicular salvage in acute testicular torsion at a tertiary pediatric center. Western Journal of Emergency Medicine, 2015.PMID 25671040
- [9]MacDonald C, Kronfli R, Carachi R, et al. A systematic review and meta-analysis revealing realistic outcomes following paediatric torsion of testes. Journal of Pediatric Urology, 2018.PMID 30404723
- [11]Stillwell TJ, Kramer SA. Intermittent testicular torsion. Pediatrics, 1986.PMID 3714385