{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:19:24Z","timestamp":1774858764647,"version":"3.50.1"},"reference-count":52,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Objective: Testicular torsion (TT) is a medical emergency, difficult to identify solely through clinical evaluation. This study aims to develop an assessment algorithm with a safe lower threshold for complementary ultrasound. \nMaterial and methods: Males between 1 and 30 years of age assessed for suspected TT during the years 2019 \u2013 2023 were retrospectively included. Clinical assessments were conducted by primarily nonurologists and ultrasounds by radiologists. An assessment algorithm named Testicular torsion Point-based Assessment and Imaging tool - identifying Need for Surgical exploration (TPAINS) was developed based on symptoms showing significant correlation with TT.\nResults: Of the 417 patients included, 68 (16%) were surgically explored and 33 (8%) diagnosed with TT. Six symptoms showing a significant association with TT were combined for the development of the algorithm TPAINS. With a cut-off value of \u22652 points, TPAINS showed a sensitivity of 100% (confidence interval, CI: [90, 100]), specificity 54% (CI [49 \u2013 59]), and an AUC-value of 0.89 (95% CI [84 \u2013 94]). \nConclusions: This study concludes that symptom-based evaluation, together with a low threshold for ultrasound, is a promising approach for the detection of TT. The developed algorithm, TPAINS, includes an ultrasound assessment and focuses on safe lower thresholds for further clinical actions \u2013 hoping for a reduced rate of unnecessary surgical explorations.<\/jats:p>","DOI":"10.2340\/sju.v61.45578","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T07:34:09Z","timestamp":1774856049000},"page":"92-98","source":"Crossref","is-referenced-by-count":0,"title":["Testicular torsion Point-based Assessment and Imaging tool - identifying Need for Surgical exploration (TPAINS): a clinical algorithm for detecting testicular torsion"],"prefix":"10.2340","volume":"61","author":[{"given":"Nathalie","family":"Dahlgren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustav","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotta","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Wagenius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"147080","doi-asserted-by":"crossref","unstructured":"Leone N, Morlacco A, D\u2019Elia C, et al. 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