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Special Feature
May 1998

Radiological Case of the Month

Arch Pediatr Adolesc Med. 1998;152(5):504. doi:

Figure 1. Abdominal radiograph showing a calcification in the lower quadrant that is a tooth in the dermoid cyst.

Figure 2. Left, Ultrasonographic scan shows an adnexal mass with cystic and solid components. Right, The same mass showing an echogenic structure with shadowing (tooth).

Ovarian torsion usually occurs in women during their reproductive years,1 but it may occur prenatally or in women after menopause.2,3 Patients older than neonates present with acute localized pain and vomiting or fever.1,4 Of girls 3 to 11 years of age, one third present with diffuse pain.5 The pain is proportionate to the degree of circulatory compromise from torsion, and if torsion is complete, the pain is acute and severe and is accompanied by nausea and vomiting.6,7 Spontaneous detorsion may occur and the pain will subside. Right ovarian torsion is slightly more common than left ovarian torsion. Bilateral torsion is rare, and even more infrequently observed is sequential torsion of the other ovary.8,9 The nonspecific nature of the presenting symptoms may result in a delay in the diagnosis.4,10