Uterine position in adnexal torsion: specificity and sensitivity of ipsilateral deviation of the uterus

Ipsilateral deviation of the uterus (IDU) has been suggested to be specific for torsion.To investigate the sensitivity and specificity of IDU in diagnosing torsion.We retrospectively reviewed the pelvic US examinations in girls performed at Nationwide Children's Hospital in 2007 and compared the uterine position in girls with a normal US scan (group 1) or with adnexal masses (group 2) with the uterine position in girls with torsion (group 3).Uterine deviation was found in 7 of 297 girls (2%) in group 1 and in 6 of 47 (13%) in group 2, and was attributed to stool in the colon splaying the adnexa and uterus. In group 3, 18 of 44 girls (41%) had moderate or marked uterine deviation and none was associated with stool displacing the uterus. Uterine deviation was more common and severe in girls in group 3 than in girls in group 1 (P0.001) and group 2 (P=0.010). The sensitivity and specificity of IDU for torsion were 41% and 98%, respectively.IDU is more common in adnexal torsion than in other causes of adnexal masses. With supporting clinical and imaging findings, IDU appears to be a specific marker for torsion.