What is the TWIST (Testicular Workup for Ischemia and Suspected Torsion) scoring system?

Updated: Aug 31, 2018
  • Author: Oreoluwa I Ogunyemi, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

The TWIST (Testicular Workup for Ischemia and Suspected Torsion) scoring system was developed for the purpose of determining the risk of testicular torsion on clinical grounds, thus decreasing the indication for ultrasound. [23] TWIST has been validated when scored by nonurological nonphysician providers as well as urologists. [24] TWIST consists of the following urological history and physical examination parameters:

  • Testis swelling (2 points)
  • Hard testis (2)
  • Absent cremasteric reflex (1)
  • Nausea/vomiting (1)
  • High-riding testis (1)

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