495 - Multicenter prospective validation of different scores for the diagnosis of testicular torsion in children.

Testicular torsion (TT) is an urological emergency requiring emergent intervention. Doppler ultrasound is commonly used to make the diagnosis. Nevertheless, Doppler ultrasound is not always available.
Different scores have been used to identify children with testicular pain presenting to the ED at high or low risk for testicular torsion (TT). The TWIST score is a useful, sensitive and specific tool for the management of these children. However, a recently developed score (TT score) has shown better performance in a unicenter study.

Objective:

The main objective was to validate clinical scores (Twist, TT, AIS, BALS) when evaluating in the pediatric emergency department (ED) children younger than 18 years old with non-traumatic testicular pain.

Design/Methods: Between November 2020 to June 2022 we carried out an observational multicenter prospective study including children 3 months-18 years old presenting with non-traumatic unilateral testicular pain to 21 pediatric ED included in the Research Network of the Spanish Society of Pediatric Emergencies (RISeuP-SPERG). TT was diagnosed by surgical intervention or ultrasound after manual detorsion. Patients were followed up by phone at 2 weeks.

Results:

We included 903 patients (median age 11 years, IQR 9-12). Of these, 93 patients had testicular torsion (10.3%, 95% CI 8.5-12.5). The performance of the scores is shown in the table, using the cut-off points in which no TT is misclassified.

 

Conclusion(s):

TWIST, TT score, BALS and AIS scores show a good performance to identify children with TT. TT score identifies a larger group of patients suitable for a safe management without Doppler ultrasound.