Obligatory medical device diagnostics.
- Scrotal sonography (ultrasound examination of the scrotal organs/testis and epididymis and their vascular supply) using Doppler sonography (special ultrasound examination that measures the flow velocity of blood in the vessels (arteries and veins)):
- Testicular torsion (twisting of the testis) is considered to be proven when there is evidence of the absence of central perfusion (blood flow of central vessels; see below). Furthermore, the testicular vessels (blood vessels of the testis) in the area of the funiculus spermaticus (bundle of vessels, nerves and the vas deferens) should be visualized. If these present themselves as a spiral in the course, there is also a high probability of testicular torsion (sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, i.e. a positive finding:) 96 %).
- If a mass (testicular tumor with hemorrhage) is present, this is also detectable by sonography.
- In the case of epididymo-orchitis (epididymitis), an inhomogeneously enlarged epididymis and hyperperfusion (increased blood flow) of the testis or the epididymis can be demonstrated
Doppler sonography of the testis – assessment of central perfusion (modified from).
| Arterial | Negative | positive | positive | |
| Venous | Negative | negative | negative | |
| Further | Central hyperemia | |||
| Diagnosis | No perfusion | Inferior perfusion | Orchitis (testicular inflammation) | Additional information needed: e.g., epididymis, hydatid, tumor |
| Differential diagnoses | Testicular torsion, incarcerated inguinal hernia. | partial torsion of the testis | intermittent testicular torsion |
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification
- Computed tomography (CT) of the abdomen (abdominal CT) – for further diagnosis.
- Magnetic resonance imaging of the pelvis (pelvic MRI) or scintigraphy (imaging nuclear medicine procedure) – to assess testicular perfusion.