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To develop a clinical decision tool for identifying children at low risk for testicular torsion, investigators prospectively enrolled patients <21 years of age presenting to a pediatric emergency department with scrotal pain for ≤72 hours. History and physical exam findings used to derive the decision tool were recorded before diagnostic imaging or surgical evaluation.
Of 228 patients (mean age, 10 years) who were evaluated for testicular pain over a 32-month period, 21 (9%) were diagnosed with testicular torsion. Among 222 patients (97%) who underwent Doppler ultrasound, the two most common pathological diagnoses were torsion of the appendix testis (23%) and epididymitis/orchitis (20%). Among the 6 patients who did not undergo ultrasound, 1…