The Role of Ultrasound in the Diagnosis of Pelvic Pain in Non-Pregnant Females

In: Pakistan BioMedical Journal · 2022 · pp. 08–11 · doi:10.54393/pbmj.v5i11.823 · W4320056955
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This study found that ultrasound imaging is crucial for diagnosing pelvic pain in non-pregnant females, with bulky uterus with fibroid and ovarian cyst being the most common findings.

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This cross-sectional study evaluated how effectively B-mode ultrasonography could diagnose causes of acute pelvic pain in non-pregnant females presenting at multiple hospitals, using an ultrasound gel to reduce artifacts and attenuation. Among 97 participants, the most common ultrasound findings were uterine fibroids with a bulky uterus (26.8%) and ovarian cysts (16.4%), with less frequent findings including endometriosis (4.1%) and endometriotic cysts (6.2%), as well as pelvic inflammatory disease and other gynecologic/non-gynecologic causes. A key limitation is that the paper reports the distribution of ultrasound findings rather than diagnostic performance metrics such as sensitivity/specificity versus a reference standard. Relevance to endometriosis: the study explicitly reports endometriosis and endometriotic cysts detected on ultrasound as causes of pelvic pain, though the paper’s main focus is the overall diagnostic role of ultrasound in acute pelvic pain rather than endometriosis specifically.

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Abstract

Pelvic pain is the most common concern among women who visit the ER, and ultrasonography should be the first imaging method used to evaluate these patients. Objectives: To evaluate how well ultrasonography could diagnose different causes that can lead to pelvic pain in women. Methods: A cross-sectional study was held at Chatha Hospital, Al Amin Diagnostic Center, and Gondal Hospital. It used B mode ultrasonographic capability and in order to avoid artifacts or attenuation, an ultrasonic gel is applied to the transducer. Hospitals were legally authorized to take the information. Inclusion criteria were used to determine patient eligibility. Results: The commonest ultrasonography findings of pelvic pain were an ovarian cyst in 16 out of 97 which were 16.4%, bulky uterus with fibroid in 26 patients (26.8%), endometriosis in 4 patients (4.1%), ovarian enlargement in 3 patients (3.1%), endometriotic cyst in 6 patients (6.2%), RPCOs in 8 patients (8.2%), PCOs in 9 patients (9.3%), hydronephrosis in 4 patients (4.1%), fluid in cul de sac in 7 patients (7.2%), thickened endometrium in 3 patients (3.1%), pelvic inflammatory disease in 5 patients (5.2%), appendicitis in 4 patients (4.1%), and inguinal hernia in 2 patients (2.1%). Conclusions: Ultrasound scanning is a critical modality for detecting pelvic changes in female patients. The most common cause of pelvic in females is uterine fibroid and ovarian cyst. Moreover, pelvic pain occurs most frequently during the reproductive age and less frequently during menopause
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The Role of Ultrasound in the Diagnosis of Pelvic Pain in Non-Pregnant Females Role of Ultrasound in the Diagnosis of Pelvic Pain DOI: https://doi.org/10.54393/pbmj.v5i11.823Keywords: Acute pelvic pain, non-pregnant females, PID, UltrasoundAbstract Pelvic pain is the most common concern among women who visit the ER, and ultrasonography should be the first imaging method used to evaluate these patients. Objectives: To evaluate how well ultrasonography could diagnose different causes that can lead to pelvic pain in women. Methods: A cross-sectional study was held at Chatha Hospital, Al Amin Diagnostic Center, and Gondal Hospital. It used B mode ultrasonographic capability and in order to avoid artifacts or attenuation, an ultrasonic gel is applied to the transducer. Hospitals were legally authorized to take the information. Inclusion criteria were used to determine patient eligibility. Results: The commonest ultrasonography findings of pelvic pain were an ovarian cyst in 16 out of 97 which were 16.4%, bulky uterus with fibroid in 26 patients (26.8%), endometriosis in 4 patients (4.1%), ovarian enlargement in 3 patients (3.1%), endometriotic cyst in 6 patients (6.2%), RPCOs in 8 patients (8.2%), PCOs in 9 patients (9.3%), hydronephrosis in 4 patients (4.1%), fluid in cul de sac in 7 patients (7.2%), thickened endometrium in 3 patients (3.1%), pelvic inflammatory disease in 5 patients (5.2%), appendicitis in 4 patients (4.1%), and inguinal hernia in 2 patients (2.1%). Conclusions: Ultrasound scanning is a critical modality for detecting pelvic changes in female patients. The most common cause of pelvic in females is uterine fibroid and ovarian cyst. Moreover, pelvic pain occurs most frequently during the reproductive age and less frequently during menopause References Patel MD, Young SW, Dahiya N. Ultrasound of pelvic pain in the nonpregnant woman. 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Langmuir. 2011 Sep; 27(17):10412-20. doi: 10.1021/la2013705 Chamié LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics. 2011 Aug; 31(4):E77-100. doi: 10.1148/rg.314105193 Yitta S, Mausner EV, Kim A, Kim D, Babb JS, Hecht EM, et al. Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary? Emergency Radiology. 2011 Oct; 18(5):371-80. doi: 10.1007/s10140-011-0962-7 Wallace GW, Davis MA, Semelka RC, Fielding JR. Imaging the pregnant patient with abdominal pain. Abdominal Radiology. 2012 Oct;37(5):849-60. doi: 10.1007/s00261-011-9827-5 Abramowicz JS. Benefits and risks of ultrasound in pregnancy. Seminars in Perinatology. 2013 Oct; 37(5):295-300. doi: 10.1053/j.semperi.2013.06.004 Park SB, Han BH, Lee YH. Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period. Medical Ultrasonography. 2017 Apr; 19(2):218-223. doi: 10.11152/mu-929 Nisenblat V, Prentice L, Bossuyt PM, Farquhar C, Hull ML, Johnson N. Combination of the non-invasive tests for the diagnosis of endometriosis. Cochrane Database of Systematic Reviews. 2016 Jul; 7(7):CD012281. doi: 10.1002/14651858.CD012281 Vandermeer FQ and Wong-You-Cheong JJ. Imaging of acute pelvic pain. Clinical Obstetrics and Gynecology. 2009 Mar; 52(1):2-20. doi: 10.1097/GRF.0b013e3181958173 Mazzei MA, Guerrini S, Cioffi Squitieri N, Cagini L, Macarini L, Coppolino F, et al. The role of US examination in the management of acute abdomen. Critical Ultrasound Journal. 2013 Dec; 5(1):1-9. doi: 10.1186/2036-7902-5-S1-S6. Downloads Published How to Cite Issue Section License Copyright (c) 2023 Pakistan BioMedical Journal This work is licensed under a Creative Commons Attribution 4.0 International License. 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