EM Quick Hits Video on Ovarian Torsion Myths with Brit Long
Myths in the utility of clinical features in diagnosis of ovarian torsion
- Myth: Ovarian torsion only occurs in women of reproductive age. Ovarian torsion affects women of all ages including children, postmenopausal and pregnant women.
- Myth: My patient’s pain is mild, and she has had it off and on for a few days. This cannot possibly be torsion, right? The classic presentation of ovarian torsion is not always present; patients may have intermittent pain or no pain at all. Intermittent torsion can occur. Only 50% of patients have acute, severe pain.
- Myth: My patient is minimally tender, and no mass can be palpated on bimanual examination. Therefore, torsion can be ruled out. Do not rely on a normal abdominal, pelvic, or bimanual examination to rule out torsion. Literature suggests the abdominal and bimanual exams, whether conducted by emergency clinicians or obstetricians, do not have adequate sensitivity (23-26%). Our bimanual exam often fails to detect ovarian masses < 5 cm in diameter.
If your patient has lower quadrant pain but an otherwise unrevealing evaluation, keep torsion on the differential.
The Podcast: EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds
In each EM Quick Hits Video, our team hand picks an EM Quick Hits podcast segment and curates a video to enhance you multimodal learning.
Our EM Quick Hits Video team is: Lara Murphy, Yajur Iyengar and Jonathan Whittall
Leave A Comment