The Significance of the Spiculated Outline of the Uterine Cavity on Hysterography

A review of 8,000 hysterograms showed 800 to be abnormal, 29 with a typical spiculated outline of the uterine cavity (not to be confused with that seen in internal endometriosis, endometrial cancer, venous reflux, or the double uterine outline sometimes found in the cycle's secretory phase). Spiculation was found in thin, inactive endometria and sometimes in atrophic ones as a result of naturally low estrogen production (both pre- and postmenopausal) or from pathological conditions, i.e., tuberculosis, or atrophy caused by taking birth control pills. Hence, the spiculated uterine contour in women near menopause is normal, but in younger women, one should suspect a pathologic, hypoplastic endometrium.