Unjumbling the TWIST score for testicular torsion: systematic review and meta-analysis

This systematic review and meta-analysis evaluates the TWIST scoring system for diagnosing testicular torsion in acute scrotum presentations. Analysis of 1,940 patients demonstrates optimal diagnostic performance at cut-off scores of 5 (for confirming torsion) and 2 (for excluding torsion), with the tool showing high specificity and practical utility in emergency department settings.