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January 27, 1984

Scrotal Imaging Techniques

Author Affiliations

Erie County Medical Center Buffalo

JAMA. 1984;251(4):469. doi:10.1001/jama.1984.03340280025015

To the Editor.—  I found the recent article by Haynes et al1 entitled "The Diagnosis of Testicular Torsion" to be state of the art clinically; however, the authors failed to discuss fully state-of-the-art scrotal imaging techniques.The authors aptly discussed radionuclide scrotal scanning, which can, with a high degree of probability, distinguish between avascular torsion and less emergent conditions, and the use of the Doppler flowmeter, which allows the examiner to evaluate blood flow to the testes. However, they failed to discuss the use of B-scan and real-time ultrasound techniques, which are, given the appropriate clinical setting, more accurate than other imaging modalities in demonstrating scrotal pathologic conditions.Bird et al,2 in a thorough discussion of B-scan ultrasound findings in testicular torsion, were, when given appropriate clinical information, able to exclude torsion and demonstrate chronic missed torsion and epididymitis without using correlative imaging modalities. However, because of overlapping