TWIST score (testicular torsion)
TWIST score (Barbosa 2013): a 0-7 point-of-care score for suspected testicular torsion from testicular swelling (2), hard testis (2), absent cremasteric reflex (1), nausea/vomiting (1), and high-riding testis (1).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Testicular swelling
- Yes
- Hard testis
- No
- Absent cremasteric reflex
- Yes
- Nausea / vomiting
- Yes
- High-riding testis
- Yes
Result: TWIST 5 of 7 -- high risk (about 87% torsion -- consider direct surgical exploration).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0-2
- Low risk (about 2% torsion); ultrasound usually unnecessary.
- 3-4
- Intermediate risk; obtain scrotal ultrasound.
- 5-7
- High risk (about 87% torsion); consider direct surgical exploration. Time-critical.
What you enter
- Testicular swelling (2)
- Hard testis (2)
- Absent cremasteric reflex (1)
- Nausea / vomiting (1)
- High-riding testis (1)
How this is calculated
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. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.