@article{92b2e7b6-7e0b-4bb5-8932-ef274279c551,
  abstract     = {{<p>Objective: Testicular torsion (TT) is a medical emergency, difficult to identify solely through clinical evaluation. This study aims to develop an assessment algorithm with a safe lower threshold for complementary ultrasound. Material and methods: Males between 1 and 30 years of age assessed for suspected TT during the years 2019 – 2023 were retrospectively included. Clinical assessments were conducted by primarily nonurologists and ultrasounds by radiologists. An assessment algorithm named Testicular torsion Point-based Assessment and Imaging tool-identifying Need for Surgical exploration (TPAINS) was developed based on symptoms showing significant correlation with TT. Results: Of the 417 patients included, 68 (16%) were surgically explored and 33 (8%) diagnosed with TT. Six symptoms showing a significant association with TT were combined for the development of the algorithm TPAINS. With a cut-off value of ≥2 points, TPAINS showed a sensitivity of 100% (confidence interval, CI: [90, 100]), specificity 54% (CI [49 – 59]), and an AUC-value of 0.89 (95% CI [84 – 94]). Conclusions: This study concludes that symptom-based evaluation, together with a low threshold for ultrasound, is a promising approach for the detection of TT. The developed algorithm, TPAINS, includes an ultrasound assessment and focuses on safe lower thresholds for further clinical actions – hoping for a reduced rate of unnecessary surgical explorations.</p>}},
  author       = {{Dahlgren, Nathalie and Sundström, Gustav and Nilsson, Charlotta and Wagenius, Magnus}},
  issn         = {{2168-1805}},
  keywords     = {{assessment algorithm; spermatic cord torsion; Testicular torsion; TWIST score; ultrasound}},
  language     = {{eng}},
  pages        = {{92--98}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Testicular torsion Point-based Assessment and Imaging tool-identifying Need for Surgical exploration (TPAINS) : a clinical algorithm for detecting testicular torsion}},
  url          = {{http://dx.doi.org/10.2340/sju.v61.45578}},
  doi          = {{10.2340/sju.v61.45578}},
  volume       = {{61}},
  year         = {{2026}},
}