What is generally the first imaging study for suspected testicular torsion?

What is generally the first imaging study for suspected testicular torsion?

• A. Color Doppler ultrasound
• B. Plain X-ray pelvis
• C. CT abdomen
• D. MRI pelvis

Answer: (A)

In suspected testicular torsion, rapid evaluation with color Doppler ultrasound is the first-choice imaging because it quickly shows blood flow to the testis and helps distinguish torsion from other causes of acute scrotum. In torsion, the affected testis typically has reduced or absent arterial flow, and the scan may reveal other signs like testicular edema or a reactive hydrocele. The ability to assess perfusion in real time makes it superior to other modalities, which don’t provide timely vascular information. Plain X-ray pelvis, CT abdomen, or MRI pelvis don’t offer the immediate, bedside assessment needed for this emergency and can delay definitive management. If the Doppler study is inconclusive or if clinical suspicion remains high, urgent surgical exploration is pursued to untwist and salvage the testis.

In suspected testicular torsion, rapid evaluation with color Doppler ultrasound is the first-choice imaging because it quickly shows blood flow to the testis and helps distinguish torsion from other causes of acute scrotum. In torsion, the affected testis typically has reduced or absent arterial flow, and the scan may reveal other signs like testicular edema or a reactive hydrocele. The ability to assess perfusion in real time makes it superior to other modalities, which don’t provide timely vascular information. Plain X-ray pelvis, CT abdomen, or MRI pelvis don’t offer the immediate, bedside assessment needed for this emergency and can delay definitive management. If the Doppler study is inconclusive or if clinical suspicion remains high, urgent surgical exploration is pursued to untwist and salvage the testis.