Gynaecological Causes of Pelvic Pain

Pelvic pain in girls is a common clinical complaint in childhood and throughout adolescence and an important cause of morbidity particularly in the postmenarchal female. Clinical evaluation in these patients is challenging. Abdominopelvic pain in the absence of a history of cyclical pain related to the menstrual cycle is a very non-specific symptom, with a range of gynaecological and non-gynaecological causes. Non-gynaecological aetiologies of pain include gastrointestinal, urological, musculoskeletal and psychosomatic disorders. Gynaecological causes of pelvic pain include complications related to ovarian cysts (cyst rupture, haemorrhage or torsion), torsion of adnexal masses or normal ovaries, and fallopian tube pathology including torsion and pelvic inflammatory disease. Other causes of pain more specific to reproductively mature adolescents include ovulatory Mittelschmerz (mid-cycle) pain, endometriosis and complications of pregnancy. Exclusion of pregnancy in this age group is an important initial step in clinical management. This chapter concentrates on the imaging of the common and important causes of acute abdominal or pelvic pain with a gynaecologic aetiology. A brief discussion of the ultrasound imaging of pregnancy is included. The role of imaging in gynaecologic conditions resulting in chronic pelvic pain syndromes is also considered. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others Abbreviations - PID: - Pelvic inflammatory disease - CT: - Computed tomography - MRI: - Magnetic resonance imaging - US: - Ultrasound - STIR: - Short-tau inversion recovery - HOC: - Haemorrhagic ovarian cyst - PIC: - Peritoneal inclusion cyst - β-hCG: - Beta human chorionic gonadotropin - HU: - Hounsfield unit - SI: - Signal intensity - AFP: - Alpha fetoprotein - WI: - Weighted-image - TSE: - Turbo spin echo - HASTE: - Half fourier acquisition single shot turbo spin echo - SPAIR: - Spectral adiabatic inversion recovery - AVR: - Adnexal volume ratio - PPV: - Positive predictive value - NPV: - Negative predictive value - 3D: - Three-dimensional - ADC: - Apparent diffusion coefficient - DWI: - Diffusion-weighted imaging - MOO: - Massive ovarian oedema - PIC: - Peritoneal inclusion cyst - IFTT: - Isolated fallopian tube torsion - ESR: - Erythrocyte sedimentation rate - TOA: - Tubo-ovarian abscess - IU: - International units - GTN: - Gestational trophoblastic disease - PHM: - Partial hydatiform mole - CHM: - Complete hydatiform mole - PSTT: - Placental site trophoblastic tumour - ETT: - Epitheliod trophoblastic tumour - FIGO: - International federation of gynaecology - AFS: - American fertility society - IV: - Intravenous - JZ: - Junctional zone

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MMWR 59(RR-12):1–116 Wright KN, Laufer MR (2011) Leiomyomas in adolescents. Fertil Steril 95:2434.e15-7 Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2011 Springer-Verlag Berlin Heidelberg About this chapter Cite this chapter Mann, G.S., Byrne, A.T., Garden, A.S. (2011). Gynaecological Causes of Pelvic Pain. In: Mann, G., Blair, J., Garden, A. (eds) Imaging of Gynecological Disorders in Infants and Children. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_436 Download citation DOI: https://doi.org/10.1007/174_2011_436 Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-540-85601-6 Online ISBN: 978-3-540-85602-3 eBook Packages: MedicineMedicine (R0)

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