The role of imaging modalities in assessment of gynaecologic causes of acute pelvic pain

Not applicable, Acute, Education, Ultrasound, MR, CT, Genital / Reproductive system female, Genitourinary Authors: A. H. A. Oraby; Alexandria/EG DOI: 10.26044/ecr2020/C-06563 Learning objectives To review the spectrum of gynaecologic pathologies resulting in acute pelvic pain. To illustrate the role of different imaging modalities used in assessment of gynaecologic causes of acute pelvic pain. To be able to choose the best imaging modality according to each condition.

Acute pelvic pain is defined as intense pain characterized by sudden onset lasting for less than 3 months.[1] Etiology: There are various gynaecologic causes such as degenerating or torsed fibroids, adenomyosis , ovarian torsion, haemorrhagic cysts, ovarian hyperstimulation syndrome, pelvic inflammatory disease, post-operative complications and ectopic pregnancy.[2] Diagnosis: For the initial diagnostic imaging evaluation, ultrasonography is the modality of choice. It allows excellent characterization and decreases or eliminates the need for imaging studies involving radiation exposure.[3] Further imaging like CT and MRI may also be... Findings and procedure details All female patients presenting with acute pelvic pain should be examined according to: I. Full history taking and clinical examination. II. Good interpretation of the laboratory results. III. Imaging evaluation (ultrasound used as the primary imaging modality in all cases followed by further CT or MRI if indicated according to each condition). IV. Follow up of the patient (operative data, pathology or imaging follow up) whenever possible. Imaging features of the most common gynaecologic causes of acute pelvic pain: I-PID: Pelvic inflammatory disease (PID) is...

Ultrasonography is the imaging modality of choice in the initial evaluation of acute pelvic pain in females. CT is performed if US is non diagnostic, or if the abnormality extends beyond the field of view achievable with the probe and further characterization is required. MR imaging is a valuable adjunct as a problem solving tool in some cases for its better soft tissue resolution. Personal information and conflict of interest A. H. A. Oraby; Alexandria/EG - nothing to disclose

1. Andreotti, Rochelle F., and Sara M. Harvey. "Sonographic evaluation of acute pelvic pain." Journal of Ultrasound in Medicine (2012); 31(11): 1713. 2. Bhosale PR, Javitt MC, Atri M, Harris RD, Kang SK, Meyer BJ, et al. ACR Appropriateness Criteria Acute Pelvic Pain in the Reproductive Age Group. Ultrasound quarterly 2016;32(2):108-15. 3. Kaproth-Joslin K,Sidhu R,Bhatt S,Voci S,Fultz P,DograV,etal.Resident and Fellow Education Feature: US Assessment of Acute Female Pelvic Pain: Test Your Knowledge.Radiographics2014;34(5):1440-1. 4. Bhavsar AK,Gelner EJ,ShormaT.Common Questions About the Evaluation of Acute Pelvic Pain. American...