Torsed appendage Diagnosis and management: Blue dot sign

Torsed appendage ranks second in causes of acute scrotal swelling in children. Yet the diagnosis and treatment in many centers lag behind the information reported in the scientific literature. Most often only a postoperative diagnosis of torsed appendage is made. The “blue dot sign” is an aid to early diagnosis. In the Children's Memorial Hospital series, a preoperative diagnosis was made in almost 30 per cent of patients with torsed appendages. Immediate surgical intervention is recommended.