TWIST score: testicular torsion risk
Estimates torsion risk in acute scrotum from five clinical signs.
Result
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Formula and thresholds
Score = swelling 2 + hard testis 2 + absent cremasteric reflex 1 + nausea/vomiting 1 + high-riding testis 1 (0–7).
Clinical note
TWIST is a triage tool and does not replace diagnosis. With a high score, ultrasound must not delay surgery. A low score does not fully exclude torsion: time of onset, age and clinical course are considered together. The score was developed with examinations by pediatric urologists; non-urologists are advised to apply the thresholds more cautiously.
This calculator is for medical professionals and does not replace clinical judgement. Do not enter the patient’s name: data is not sent anywhere and is processed only in your browser.
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