Diagnosis of endometriosis

Diagnosis of endometriosis requires careful interpretation of objective surgical and pathologic findings in the context of the patient's clinical presentation. Clinical assessment helps to identify patients at high risk of endometriosis and selects those who warrant further testing. Determination of the serum level of CA-125, and to a lesser extent, other proteins, may be helpful in evaluating selected population at risk and following the course of the disease. Selective use of imaging studies, especially ultrasound and magnetic resonance imaging, may also be helpful. Ultimately, the diagnosis of endometriosis is usually confirmed or refuted by laparoscopy, preferably performed in conjunction with histologic evaluation of excised lesions.