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The TWIST Score can be used for risk stratification of an acute scrotum, but POCUS (point-of-care ultrasound) should be used to rule out testicular torsion in pediatric patients, particularly in intermediate risk patients.
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Evaluating the TWIST score and point-of-care ultrasound for paediatric testicular torsion. Emerg Med J. 2026 Feb 23:emermed-2025-215067. doi: 10.1136/emermed-2025-215067. Epub ahead of print. PMID: 41730670.
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In this multicenter prospective study, POCUS findings were combined into a novel ECOLIC score to identify patients at low risk for urological intervention.
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Point-of-care ultrasound for risk stratification of urgent urological care in acute uncomplicated renal colic. CJEM. 2025 Dec;27(12):984-994. doi: 10.1007/s43678-025-01008-y. Epub 2025 Oct 25. PMID: 41138020.
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In patients with renal colic, absence of hematuria and hydronephrosis on point-of-care ultrasound effectively rules out obstructing kidney stones.
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The U-POCUS protocol: urinalysis and point-of-care ultrasound to exclude symptomatic ureterolithiasis in emergency department patients. CJEM. 2025 Sep 13. doi: 10.1007/s43678-025-00998-z. Epub ahead of print. PMID: 40946134.
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In this retrospective study of ED-diagnosed UTIs, Cephalexin dosed twice daily was just as effective as four times daily, with no significant difference in treatment failure – suggesting BID dosing may be a practical, adherence-friendly option in some patients.
Source
Cephalexin twice daily versus four times daily for the treatment of urinary tract infections diagnosed in the emergency department. Am J Emerg Med. 2025 Jul;93:80-85. doi: 10.1016/j.ajem.2025.03.058. Epub 2025 Mar 24. PMID: 40184663
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This review summarizes existing guidelines regarding management of complicated pediatric UTI and providing recommendations on testing, treatment and duration.
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Guidelines for Complicated Urinary Tract Infections in Children: A Review by the European Society for Pediatric Infectious Diseases. Pediatr Infect Dis J. 2025 Jun 1;44(6):e211-e223. doi: 10.1097/INF.0000000000004790. Epub 2025 Mar 19. PMID: 40106750
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There is huge variability in UTI treatment for patients with urinary tract anomalies, but no significant difference in the presence of bacteremia, ICU admission, or rate of ED revisit.
Source
Variability in Treatment of UTIs in Children With Genitourinary Anomalies in Children’s Hospitals. Hosp Pediatr. 2025 Apr 1;15(4):309-317. doi: 10.1542/hpeds.2024-007914. PMID: 40127685
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Urine dipstick testing is highly accurate for diagnosing UTI in febrile infants aged 2-6 months and may eliminate the need for initial laboratory urinalysis.
Source
Urine Dipstick for the Diagnosis of Urinary Tract Infection in Febrile Infants Aged 2 to 6 Months. Pediatrics. 2025 Apr 1;155(4):e2024068671. doi: 10.1542/peds.2024-068671. PMID: 40122108
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For prophylaxis of recurrent UTI in children, prophylactic treatment with nitrofurantoin and cranberry products were most associated with reduction in recurrence of UTI. None of the interventions reduced kidney scarring.
Sources
Prophylaxis Options in Children With a History of Recurrent Urinary Tract Infections: A Systematic Review. Pediatrics. 2024 Dec 1;154(6):e2024066758. doi: 10.1542/peds.2024-066758. PMID: 39492618
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This animal model study compared the classic median bar technique for zipper skin entrapment release to a novel approach. There was no upside or downside to using the new technique.
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Improvising on the Fly: Comparison of a Novel Technique for Emergent Zipper Release to a Well-Established Technique in a Simulated Setting. J Emerg Med. 2024 Oct;67(4):e351-e356. doi: 10.1016/j.jemermed.2024.05.001. Epub 2024 May 17. PMID: 39191623
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Prostate MRI may be a reasonable next step for patients with positive PSA screening for prostate cancer.
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Results after Four Years of Screening for Prostate Cancer with PSA and MRI. N Engl J Med. 2024 Sep 26;391(12):1083-1095. doi: 10.1056/NEJMoa2406050. PMID: 39321360