Mind Map: Testicular Torsion
Published by Vijay December 13th, 2008 in Medicine, Mind Map, Radiology, UltrasonographyNote: The inspiration to try this experimental mind map comes from the excellent collection of allergy and immunology related mind maps created by my blog & twitter friend Dr. Ves Dimov, author of the Clinical Cases and Images Blog. It might help to see my previous two casebook posts - Testicular Torsion and Acute Orchitis before you see the mind map. I made this with bubbl.us following Ves’s recommendation in this post (you can check out the features offered by bubbl.us in this mind map) and mildly modified it with Skitch. Many thanks to Enrico for telling me about Skitch, an amazing application (it works only in Mac OS X). Quite possibly the last word in simple intuitive screen grabbing and image manipulation software. Ideal for manipulating image sizes, doing simple annotations, etc. And it comes with web posting ability. I never thought I’d say this, but this is better than ImageWell.
Testicular Torsion
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You know, I won’t comment on the technology issue of this, but in scrotal pain, it is often too late when the patient presents to the surgeon, leaving no time for scans and stuff. You need to explore right away (golden 6 hours for sterility to set in from infarcts and immune damage thereof).
Rambodoc: I agree that when the patient arrives within the six hour interval he needs a surgical exploration without any loss of further time. Provided he is at high risk of torsion though.
I am sure you will agree that there is a bit of overlap between the clinical presentation and examination findings between torsion and epididymo-orchitis. An ultrasound scan of the scrotum, which takes a few minutes to perform (though it may take a while to organize) gives you the diagnosis without doubt.