Case reportThe cremasteric reflex: a useful but imperfect sign in testicular torsion
Section snippets
Case report
A 4-year, 10-month-old boy was transferred from another hospital with an 18-hour history of testicular pain. At the first hospital, urinalysis and basic bloodwork results were normal, whereas Doppler ultrasonography reportedly showed decreased blood flow to both testes. The patient was afebrile but in moderate discomfort at our facility. Scrotal examination showed a normal 1.8-cm right testis and an indurated, exquisitely tender 3.5-cm left testis. The cremasteric reflex was present
Discussion
The significance of the cremasteric reflex in testicular torsion was reported by Rabinowitz1 in 1984. This report made the remarkable observation that the loss of the reflex is a 100% sensitive test for the presence of torsion. The specificity, however, was only 66%, because the cremasteric reflex can be absent in a number of other conditions as well as in normal individuals. One subsequent study quantified the value of the reflex in the acute scrotum in 26 patients.2 Together, these 2 series
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