Imaging of Acute Gynecologic Disorders

Pelvic pain is one of the most common causes for presentation to the emergency department. A variety of gynecological processes may be the etiology for pelvic pain; hemorrhagic ovarian cysts, pelvic inflammatory disease, ovarian torsion, endometriosis, cystitis, ovarian vein thrombosis, and ovarian hyperstimulation syndrome are a few of the most commonly encountered pathologies. Before medical imaging is performed for the evaluation of pelvic pain, it is important to obtain relevant clinical history and review available laboratory information. The patient’s age and pregnancy status are of particular importance in the differential diagnosis; therefore, serum beta-hCG laboratory evaluation is performed if there is even a remote possibility of pregnancy. Transvaginal and transabdominal ultrasound are the workhorse modalities for the evaluation of pelvic pain when a gynecological etiology is suspected. Transvaginal and/or transabdominal ultrasound are both considered equally appropriate when evaluating pelvic pain; this is true whether the serum beta-hCG is positive or negative and whether a gynecologic or nongynecologic etiology is suspected.