Pelvic pain: overlooked and underdiagnosed gynecologic conditions

Ewa Kuligowska, Kuligowska E, Deeds L 3rd, Linda Deeds, Kang Lu, Lu K 3rd
Radiographics : a review publication of the Radiological Society of North America, Inc · 2005 · vol. 25(1) , pp. 3–20 · doi:10.1148/rg.251045511 · PMID:15653583 · W2103586040
Review OA: closed CC0 ⤵ 58 in-corpus citations
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This paper reviews how transvaginal ultrasound and MRI can diagnose frequently overlooked gynecologic causes of chronic pelvic pain, including endometriosis, adenomyosis, and pelvic varices.

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Abstract

Chronic pelvic pain is a common, disabling problem among women. Although chronic pelvic pain can be produced by many conditions, some gynecologic causes are frequently overlooked and underdiagnosed, resulting in inappropriate referral and inadequate treatment. The gynecologic conditions most often unrecognized are endometriosis, adenomyosis, pelvic congestion, and less common congenital and acquired abnormalities. Transvaginal ultrasonography (US) is helpful for assessing endometriotic cysts but has a limited role in the diagnosis of adhesions or peritoneal implants. The classic magnetic resonance (MR) imaging features diagnostic of endometrioma are a cystic mass with high signal intensity on T1-weighted images and loss of signal intensity on T2-weighted images. When transvaginal US findings are suggestive of adenomyosis, MR imaging is used as the definitive imaging modality for diagnosis. High-resolution transvaginal US and MR imaging can help establish the diagnosis of adenomyosis with a high degree of accuracy, since the imaging appearance closely correlates with the histopathologic characteristics. Pelvic varices can be identified by using transvaginal US with color Doppler and Doppler spectral analysis. Three-dimensional T1 gradient-echo sequences performed after the intravenous administration of gadolinium are the most effective MR imaging sequence for demonstrating pelvic varices. Blood flow in pelvic varices appears with high signal intensity. Recent advances in radiologic imaging and therapeutic procedures make it possible to diagnose accurately the conditions producing chronic pelvic pain in most women and to guide effective treatment.

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Condition tags

endometriosischronic_pelvic_painadenomyosisendometrioma

MeSH descriptors

Pelvic Pain Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans Ovary Ovary Ovary Pelvic Pain Pelvic Pain Pelvic Pain Syndrome Syndrome Vascular Diseases Vascular Diseases

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (48)

Cited by (50)

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