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Steve & All,
There is similar data in the pediatric radiology literature that quotes higher sensitivity with US assessment of the spermatic cord vs. a limited testicular US. I wonder why this is not uniformally practiced? Our sonologists tell me that the newer US machines are much better at detecting subtle changes in blood flow or is it a training issue? At the end of the day, if clinical suspicion is high, exploration is still the best strategy! 
Cheers
Jay 
Jay Pershad,
Le Bonheur ED

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From: Steve Socransky <[log in to unmask]>
Here's one of the more recent and better articles on the topic:
Kalfa et al.  Multicenter Assessment of Ultrasound of the Spermatic Cord in Children With Acute Scrotum.  J Urol. 2007; 177:297-301.
Steve

-----Original Message-----
Steve,
Point taken! Similar to your hospital, reviewing the spermatic cord for a "twist" is not part of the protocol for our our US techs and radiologists. 
JP 
Jay Pershad


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