Diagnostic Accuracy of C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Acute Scrotum

Department of Urology, Razi Hospital, Gilan University of Medical Sciences, Rasht, Iran.
Urology journal (Impact Factor: 0.71). 01/2006; 3(2):104-8.
Source: PubMed

ABSTRACT Our aim was to investigate the diagnostic accuracy of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with acute scrotum.
One hundred and twenty patients with acute scrotum were evaluated and divided into 3 groups: 46 with acute epididymitis (group 1), 23 with spermatic cord torsion (group 2), and 51 with other noninflammatory causes of acute scrotum (group 3). Serum levels CRP and ESR were measured at the time of admission.
Of the patients in group 1, 44 (95.6%) had elevated serum levels of CRP (mean, 67.77 +/- 47.80 mg/L). In contrast, only 1 patient in group 2 had a significant increase in the serum level of CRP (mean, 9.0 +/- 4.90 mg/L), and the patients in group 3 did not have any significant increase in the CRP levels (mean, 7.0 +/- 2.2 mg/L) (P < .001). The mean ESR values were 45.9 +/- 21.4 mm/h, 14.2 +/- 11.2 mm/h, and 8.8 +/- 7.5 mm/h, in groups 1 to 3, respectively (P < .001). The cutoff points for distinguishing between epididymitis and noninflammatory causes of acute scrotum were 24 mg/L for CRP and 15.5 mm/h for ESR. The sensitivity and specificity values were 93.4% and 100% for CRP and 95.6% and 85.1% for ESR, respectively.
Based on our findings, serum levels of CRP and ESR can provide helpful information for differentiation between epididymitis and other causes of acute scrotum. We recommend CRP and ESR measurements before making a decision of surgical intervention.

Download full-text


Available from: Gholamreza Mokhtari, Jan 23, 2014
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The differential diagnosis of an acute scrotum is of great importance in clinical practice and may be difficult in some cases. The aim of this study was to differentiate inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests which can be performed quickly and easily outside a hospital setting. PATIENTS AND METHODS: From 2007 to 2010, 85 boys with acute scrotum were included in this prospective study. There were 28 boys with inflammatory and 57 with non-inflammatory causes. We investigated the role of erythrocyte sedimentation rate, C-reactive protein, leukocyte, white blood cell differential count, alkaline phosphatase, creatine kinase and child's age in differential diagnosis of the acute scrotum, differentiating inflammatory from non-inflammatory causes of the disease. We used receiver operating characteristics (ROC) analysis and logistic regression analysis. RESULTS: Statistically significant parameters in accurate differentiation between inflammatory and non-inflammatory causes of the acute scrotum were C-reactive protein (p = 0.001) and child's age (p < 0.001). These two parameters yielded the probability of an inflammatory outcome in the etiology of acute scrotum with sensitivity of 75% and specificity of 69.1%. CONCLUSION: C-reactive protein and child's age are helpful in differentiating inflammatory from non-inflammatory causes of the acute scrotum.
    Journal of pediatric urology 05/2013; 9(3):313-317. DOI:10.1016/j.jpurol.2012.03.009 · 1.41 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of the present study was to evaluate the clinical history, demographic data, surgical exploration findings, and final diagnoses in all young males presenting with acute scrotum to our center. This was a descriptive-retrospective study in which all consecutive cases of acute scrotum treated in our department from March 2008 to March 2012 were evaluated. A total of 116 cases were included in the study. Out of these cases, 100 cases underwent surgical exploration, and the remaining 16 cases were managed conservatively. Our eligible cases were divided into three groups: the testicular torsion (TT) group (68%); the torsion of the appendix testis (AT) group (20%); and the epididymo-orchitis (EO) group (9%). Testicular preservation was achieved in 39 cases of the TT group, while due to delayed referral, orchiectomy was performed in 29 cases. Thus, our testicular salvage rate was 57.5% and missed testicular torsion rate was 42.5%. It was observed that our testicular salvage rate was lower than the expected figures published in the literature. This is may be attributed to different causes, including delayed referral or presentation of acute scrotum cases, inadequate knowledge of the general practitioners working in emergency departments, or poor knowledge of parents.
    International Journal of General Medicine 01/2014; 7:75-8. DOI:10.2147/IJGM.S52413