Role of imaging modalities in assessment of gynecological causes of pelvic pain

Abstract

Background Pelvic pain is common in females present to the OB/GYN Department. Ultrasonography (US) is the first imaging modality for assessment of pelvic pain of gynecological causes, sometimes followed by computed tomography (CT) or MRI to reach diagnosis. Objective The objective was to evaluate the role of imaging modalities in assessment of gynecologic causes of pelvic pain. Patients and methods The current study included 50 cases presented to the Radiology Department in Al Azhar University Hospital complaining of pelvic pain. All patients were subjected to history taking and clinical examination. Laboratory investigations, such as B-HCG or CA125, were included for selected cases. All patients underwent US (transabdominal or transvaginal) as a primary imaging modality, then CT, or MRI when indicated. Results Patients were divided into two groups: 33 (66%) patients with acute pelvic pain and 17 (34%) patients with chronic pelvic pain. Patients with acute pelvic pain were distributed according to diagnosis into seven (21.5%) simple ovarian cysts, five (15.5%) ectopic pregnancies, four (12%)hemorrhagic cysts, three (9%) dermoids, three (9%) pelvic inflammatory disease, two (6%) endometriomas, two (6%) adenomyosis, two (6%) missed abortions, one (3%) hematocolpos, one (3%)ovarian apoplexy, one (3%) perforated intrauterine device, one (3%) ovarian mass, and one (3%) partial vesicular mole. Patients with chronic pelvic pain were distributed according to diagnosis into six (35%) leiomyomas, four (23%) ovarian masses, two (2%) dermoids, two (2%) endometriomas, one (6%) adenomyosis, one (6%) cervical cancer, and one (6%) pelvic lipomatosis. Conclusion US is the reliable imaging modality for assessment of pelvic pain of gynecological causes. CT was performed if US is inconclusive, nondiagnostic, and if abnormality was beyond the field of view. MRI was superior to CT.