Prenatal — Etiology: Occurs in utero — Clinical: presents as painless palpable hard mass with pigmentation of scrotum, 75% of torsion
Extravaginal in neonates — Etiology: torsion of spermatic cord + tunica — Imaging: absent blood flow by color + spectral doppler, heterogenous parenchyma, small anechoic areas, peripheral eggshell like hyperechogenicities, decreased or increased size of testicle, hydrocele, kiwi sign — Clinical: presents as painful red scrotum
Intravaginal in 3 – 20 year old — Etiology: torsion of spermatic cord caused by bell clapper deformity — Imaging: absent intratesticular blood flow by color + spectral doppler, whirlpool sign of spermatic cord, enlarged edematous testis