article · BMC Medical Imaging
This five-year retrospective study in a Ghanaian quaternary facility evaluated the diagnostic accuracy and imaging patterns of sonography for testicular torsion. Researchers reviewed medical records of patients with acute scrotal pain who underwent surgical exploration. The study found that testicular torsion predominantly affected adolescents, with a mean age of 15.36 years. Most patients presented late, with symptoms lasting over 6 hours. Key sonographic indicators included absent intratesticular blood flow, whirlpool sign, and heterogeneous echotexture. Ultrasound demonstrated high sensitivity (92.96%) and overall diagnostic accuracy (86.96%), though specificity was moderate. The incidence of testicular torsion showed an increasing trend over the study period, suggesting improved recognition and healthcare access.
Testicular torsion is a medical emergency where delayed diagnosis can lead to testicular loss. This research highlights the diagnostic effectiveness of ultrasound in a low-resource setting and identifies patterns of presentation, which can inform clinical practice and improve outcomes for affected individuals, particularly adolescents.
This abstract focuses on evaluating the diagnostic accuracy of an existing medical imaging technique, ultrasound, for testicular torsion in a specific clinical setting. It does not indicate an application pathway for new products, services, or technologies, nor does it suggest a readiness level for commercialisation.
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Testicular torsion is a time-critical urological emergency in which delayed diagnosis and intervention significantly increase the risk of testicular loss. In low-resource settings such as Ghana, late presentation and variability in imaging expertise may affect diagnostic accuracy and clinical outcomes. This study evaluated the sonographic diagnostic accuracy and imaging patterns of testicular torsion in a quaternary healthcare facility in Ghana over a five-year period. This study was a cross-sectional design that reviewed and evaluated the medical records of all eligible patients with acute scrotal pain who were clinically labelled cases of testicular torsion and subsequently underwent surgical exploration from January 2020 to December 2024. The data collected were analyzed using SPSS and Python. Fisher’s exact test was employed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were also calculated. Statistical significance level was set at p ≤ 0.05. The mean age of patients with confirmed testicular torsion was 15.36 ± 8.97 years, mostly observed in the 13–18 years age group ( p = 0.049). The mean duration of symptoms prior to presentation was 11.45 ± 8.01 h, with only 26.8% ( p < 0.001) of patients presenting within 6 h of symptom onset, while 73.2% presented after 6 h ( p < 0.001). Absent intratesticular blood flow, whirlpool sign, and heterogeneous echotexture were seen in 81.7% ( p < 0.001), 64.8% ( p = 0.001), and 62.0% ( p = 0.027) of patients with confirmed testicular torsion, respectively. Ultrasound demonstrated a sensitivity of 92.96%, specificity of 66.67%, and overall diagnostic accuracy of 86.96%, with a PPV of 90.41% and an NPV of 73.68%. The cumulative incidence rate of testicular torsion from 2020 to 2024 was 3.43 (95% CI = 2.63–4.23) per 100,000 males. Testicular torsion predominantly affected adolescents and was characterized by delayed presentation and advanced sonographic features of ischemia. Scrotal ultrasound showed high sensitivity and diagnostic accuracy but moderate specificity and NPV. The steady increase in the incidence of testicular torsion from 0.29 per 100,000 in 2020 to 1.16 per 100,000 in 2024 suggests improved recognition and reporting, as well as greater healthcare access over time.
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DOI: 10.1186/s12880-026-02725-1
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