SynthesisEmergency radiology2018
The ultrasonographic "whirlpool sign" in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis.
Synthesis in Emergency radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Recurrent testicular torsion post orchidopexy - an occult emergency: a systematic review.ANZ journal of surgery · 2022Pooled it
- The role of ultrasound imaging in adult patients with testicular torsion: a systematic review and meta-analysis.Journal of medical ultrasonics (2001) · 2019Pooled it
- Revisiting the Role of Ultrasound in Pediatric Scrotal and Groin Pathology.Current urology reports · 2026Review
- Hurdles to boys with acute scrotal pain being evaluated and treated in district general hospitals: we are not Getting It Right the First Time yet.Annals of the Royal College of Surgeons of England · 2025Article
- Clinical characteristics and treatment analysis of neonatal testicular torsion.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Utility of cine clips of the spermatic cord in the diagnosis of testicular torsion in the pediatric population.Pediatric radiology · 2025Article
- Clinical characteristics and management strategies of testicular torsion in children with cryptorchidism: a comprehensive analysis.Translational andrology and urology · 2025Article
- Predictive factors for manual detorsion success in testicular torsion.International urology and nephrology · 2024Article
- Article
- Management of acute testicular pain in children: changing trends with improvements in scrotal ultrasonography over 18 years.Singapore medical journal · 2023Article
- Microvascular imaging ultrasound (MicroV) and power Doppler vascularization analysis in a pediatric population with early scrotal pain onset.Japanese journal of radiology · 2022Article
- The diagnostic value of ultrasound in pediatric testicular torsion with preserved flow.Frontiers in pediatrics · 2022Article
- The limits of diagnosis of testicular torsion in the child: Medicolegal implications in clinical practice.Clinical case reports · 2021Article
- Testicular Torsion in Monorchism Diagnosed with Point-of-care Ultrasound: A Case Report.Clinical practice and cases in emergency medicine · 2021Article
- Acute scrotal pain in pediatric patients: diagnosis with an innovative Doppler technique (MicroV).Emergency radiology · 2021Article
- Testicular Torsion in the Emergency Room: A Review of Detection and Management Strategies.Open access emergency medicine : OAEM · 2020Review
- Establishment and internal validation of preoperative nomograms for predicting the possibility of testicular salvage in patients with testicular torsion.Asian journal of andrologyArticle
- Neonatal testicular torsion.African journal of paediatric surgery : AJPSReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis.
methodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Selected studies were further assessed for relevance and quality using the Oxford 2010 Critical Appraisal Skills Program (CASP).
resultsOf the studies assessed, a total of 723 participants were included, with a mean of 72.3 (SD 71.9) participants. Of the participants, 226 (31.3%) were diagnosed with testicular torsion (TT). Meta-analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity of the WS of 0.73 (95% CI, 0.65-0.79) and 0.99 (95% CI, 0.92-0.99), respectively. Removal of all neonates increased the pooled sensitivity to 0.92 (95% CI, 0.70-0.98) while the pooled specificity remained almost unchanged at 0.99 (95% CI, 0.95-1.00). The estimated summary effect of all studies with sufficient data was 4.34 (95% CI, 1.01-7.67; n = 394; p = 0.001). A large degree of heterogeneity was suggested by an I
conclusionThe WS, when correctly diagnosed, may be viewed as a very definitive sign for TT in the pediatric and adult populations. However, its role in neonates is limited.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.