cliot (version 1.0.0)

twist_score: Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score

Description

Calculates the TWIST Score to stratify the risk of testicular torsion in male patients presenting with acute scrotal pain. The score helps identify patients who may require immediate surgical exploration versus those who can be safely managed with ultrasound or clinical observation.

Usage

twist_score(testicular_swelling, hard_testicle, absent_cremasteric_reflex,
            nausea_vomiting, high_riding_testicle)

Value

A list containing:

TWIST_Score

The calculated total score (Range 0-7).

Risk_Category

Classification (Low: 0-2, Intermediate: 3-4, High: 5-7).

Recommendation

Clinical guidance regarding imaging and consultation.

Arguments

testicular_swelling

Numeric (0 or 1). Presence of testicular swelling. (1 = Yes, +2 points).

hard_testicle

Numeric (0 or 1). Presence of a hard testicle on palpation. (1 = Yes, +2 points).

absent_cremasteric_reflex

Numeric (0 or 1). Absence of the cremasteric reflex. (1 = Yes, +1 point).

nausea_vomiting

Numeric (0 or 1). Nausea or vomiting. (1 = Yes, +1 point).

high_riding_testicle

Numeric (0 or 1). High-riding testicle. (1 = Yes, +1 point).

References

Barbosa JA, Tiseo BC, Barayan GA, et al. Development and initial validation of a scoring system to diagnose testicular torsion in children. J Urol. 2013;189(5):1859-1864. doi:10.1016/j.juro.2012.10.056

Examples

# Example 1: High Risk
# Swelling (1), Hard (1), No Reflex (1), Nausea (0), High Riding (0)
# Score = 2 + 2 + 1 = 5
twist_score(1, 1, 1, 0, 0)

# Example 2: Low Risk
# No swelling, soft testicle, reflex present (0), nausea (1), normal position
# Score = 1
twist_score(0, 0, 0, 1, 0)