Accuracy of point-of-care ultrasound by pediatric emergency physicians for testicular torsion

Friedman, Nir; Pancer, Zachary; Savic, Ranko; Tseng, Felicia; Lee, Michelle S.; McLean, Les; Bägli, Darius; Tessaro, Mark O.

doi:10.1016/j.jpurol.2019.07.003

Cited by 35 publications

(52 citation statements)

References 27 publications

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“…Point-of-care ultrasonography is inexpensive and has been shown to be a reliable means of diagnosing testicular torsion. 7 This study highlights the success of a curriculum to teach an interdisciplinary group of residents with varying prior experience with POCUS the skills required to perform scrotal POCUS for identification of testicular torsion. Knowledge, confidence, comfort were all im proved after the curriculum.…”

Section: Discussionmentioning

confidence: 88%

“…In Ontario, the cost of POCUS performed by an emergency physician falls within the physician's original assessment fee, whereas formal Doppler ultrasonography costs $47.30 to perform and $23.80 for a radiologist to interpret the sonograms. 6 Friedman and colleagues 7 reported that POCUS for acute scrotum assessment had a specificity of 99% and agreement of 70% compared to formal Doppler ultrasonography. More important, agreement was 100% for true testicular torsion, and all true-positive cases were identified by POCUS.…”

Section: Discussionmentioning

confidence: 99%

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Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum

Stringer

Cocco

Jiang

et al. 2021

cjs

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Background: Prompt Doppler ultrasonography to aid in diagnosis is often key to managing testicular torsion, but there may be delays in access; a faster, more widely available alternative is point-of-care ultrasonography (POCUS). The purpose of this study was to develop and evaluate a scrotal POCUS curriculum for urology and emergency medicine residents. Methods: Content experts in urology, emergency medicine and diagnostic imaging collaborated in a modified Delphi method to design a practical didactic curriculum for scrotal POCUS for the identification of testicular torsion. Training included 3 online video teaching modules and a 1-hour hands-on teaching session with standardized adult patients. We evaluated participants’ competency in scrotal POCUS using a validated scale. We assessed participants’ knowledge, comfort and confidence in performing scrotal POCUS before and after the intervention and at 3 months. Results: Twenty-four urology (n = 12) and emergency medicine (n = 12) residents participated in the curriculum. After hands-on practice, 23 participants (96%) were deemed competent at scrotal POCUS. Pre–post testing showed significant improvement in knowledge (mean score 63% v. 80%, p < 0.001), comfort (mean Likert score 0.6 v. 3.6, p < 0.001) and confidence (mean Likert score 1.0 v. 2.1, p < 0.001) after the intervention. These effects were maintained at the 3-month assessment. Conclusion: The scrotal POCUS curriculum was effective and acceptable to both urology and emergency medicine residents. The findings suggest that scrotal POCUS can be learned effectively through a short hands-on session and didactic instruction.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum

Stringer

Cocco

Jiang

et al. 2021

cjs

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“…Ultrasound is also a safe imaging option compared to CT or X-ray, as there is no ionizing radiation exposure. 1 1 2 3 1…”

Section: Introductionmentioning

confidence: 99%

“…Family Medicine Physicians have traditionally used ultrasound most often during obstetric related care and when available for musculoskeletal injuries. POCUS improves both the sensitivity and specificity with which clinicians can make a variety of diagnoses from abdominal aortic aneurysm to testicular torsion [ 1 - 3 ]. Using a compact ultrasound machine at the patient's bedside also improves the speed at which physicians are able to make a clinical diagnosis, which in turn hastens both initial treatment and disposition decisions [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Application of Point-of-Care Ultrasound for Family Medicine Physicians for Abdominopelvic and Soft Tissue Assessment

Frasure¹,

Dearing²,

Burke³

et al. 2020

Cureus

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Point-of-care ultrasound (POCUS) improves both the sensitivity and specificity with which clinicians can make a variety of diagnoses at the bedside from abdominal aortic aneurysm to kidney stones. In outpatient clinics, urgent care centers, and emergency departments, where ultrasound imaging may be delayed by hours or even days, the use of POCUS can be very helpful. We believe that POCUS facilitates both the triage of patients and provides diagnostic information quickly. We hope to advance the use of POCUS in the primary care setting and have reviewed six sonographic topics where we believe ultrasound can be of immense assistance to the physician in the outpatient setting.

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“…Acute scrotal pain is one of the common presentations in emergency departments (EDs). 1 Testicular torsion is the first differential of timesensitive emergencies in any acute scrotal pain presenting as a pediatric emergency. Ultrasound has been used for diagnosis since the 1970s.…”

Section: Introductionmentioning

confidence: 99%

Point‐of‐Care Ultrasound detecting testicular rupture in pediatric emergency

Raml

Jamjoom

2020

JACEP Open

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Acute scrotal pain is a true emergency that needs to be identified, diagnosed, and managed quickly to avoid any testicular tissue loss. In pediatric emergency, testicular torsion has been the most worrisome diagnosis that needs to be included or excluded as fast as possible. Point-of-care ultrasound (POCUS) has been reported to be a game changer. However, because testicular rupture is an extremely rare entity in the pediatric age group, there are limited reports about POCUS use in diagnosing the condition. We describe a case of a 4-year-old boy who presented with acute scrotal pain secondary to trauma 2 days previous, where POCUS was able to identify and diagnose testicular rupture in a timely fashion that facilitated management and intervention.

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Accuracy of point-of-care ultrasound by pediatric emergency physicians for testicular torsion

Cited by 35 publications

References 27 publications

Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum

Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum

Application of Point-of-Care Ultrasound for Family Medicine Physicians for Abdominopelvic and Soft Tissue Assessment

Point‐of‐Care Ultrasound detecting testicular rupture in pediatric emergency

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