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October 14, 2015 0 Comments

This patient had acute onset of severe L testicular pain and could hardly walk. I thought he was a torsion for sure. However the flow was fine. I moved up to the epididymitis and sure enough it was enlarged and with increased flow.

Increased blood flow in epididymus on left.

Increased blood flow in epididymis on left.

[ed. note]  With any patient that has a high pretest likelihood of torsion, be very cautious about using POCUS as a rule out.  Remember some patients will have intermittent torsion that can result in transient hyperaemia on Doppler if they spontaneously de-torted prior to your scan.  However, in those low-risk patients it can be reassuring to see an alternate diagnosis and arrange followup on a less acute basis.

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