Path Charts for Final

Adenomyosis symptoms/signs:

Asymptomatic

-         Pelvic pain

-         Dysmenorrhea

-         Menorrhagia

Adenomyosis USA:

Diffusely enlarged heterogeneous uterus

Venetian blind-edge shadow

Occasionally myometrial cysts

Adenomyosis is common in:

Reproductive women, most symptomatic

Adenomyosis

Leiomyoma AKA Fibroid or myoma clinical S/S:

Asymptomatic

-         Pelvic pain

-         Dysmenorrhea

-         Menorrhagia

-         Infertility

-         Urinary frequency

Most common benign neoplasm of the myometrium

Fibroid/Leiomyoma

Leiomyoma AKA Fibroid USA:

Diffusely enlarged uterus

Focal heterogeneous mass

Peripheral vascularity if present

Calcifications often present especially in postmenopausal

Leiomyoma AKA Fibroid is most symptomatic in _____ ______ but occurs in all

Reproductive women

Fibroid/Leiomyoma

Leiomyosarcoma Clinical S/S:

Asymptomatic

-         Irregular bleeding

Leiomyosarcoma is _____, occurs in any

Rare

Leiomyosarcoma USA:

Focal heterogeneous mass w/irregular margins

Leiomyosarcoma

AV Malformation Clinical S/S:

-         Menorrhagia

-         Anemia

Post procedure/partum/trauma connection

AV Malformation is ______, occurs in reproductive women

Rare

AV Malformation USA:

Serpiginous anechoic structures in myometrium

Highly vascular

Mosaic color doppler

High flow, low resistance arterial evaluation

Arterialized venous evaluation

AV Malformation

Carcinosarcoma is ______ and occurs in 50-60 year olds

Rare

Carcinosarcoma Clinical S/S:

-         Bleeding

-         Pain

-         Wt loss

-         Edema in lower extremities

Carcinosarcoma USA:

Enlarged heterogeneous uterus filled w/ polypoid structures

Often hyperechoic

Carcinosarcoma

Septate Uterus is _________ in adolescents/adults

Common

Septate Uterus Clinical S/S:

Infertility, miscarriage

Septate Uterus USA:

2 endometrial canals. Normal external fundal contour

Septate Uterus

Bicornuate Uterus is ____________ in adolescents/adults

Common

Bicornuate Uterus Clinical S/S:

OB complications

Bicornuate Uterus USA:

2 endometrial canals, external indentation at uterine fundus

Bicornuate Uterus

Uterus Didelphys is rare but occurs in ___________

Adolescents

Uterus Didelphys Clinical S/S:

Dual vaginal cervix, miscarriage

Uterus Didelphys USA:

2 symmetrical horns, 2 endometrial canals and duplication of cervix

Uterus Didelphys

Unicornuate Uterus is rare but occurs in _____________

Adolescents

Unicornuate Uterus Clinical S/S:

OB complications

Unicornuate Uterus USA:

Small, laterally positioned uterus, one horn

Unicornuate Uterus

Arcuate Uterus is a ___________variant that occurs in all

Common

Arcuate Uterus Clinical S/S:

Usually asymptomatic

Arcuate Uterus USA:

Mild fundal indentation, normal endometrium

Arcuate Uterus

MRKH Syndrome is ________ but occurs in adolescents

Rare

MRKH Syndrome Clinical S/S:

Primary amenorrhea

MRKH Syndrome USA:

Absent uterus/vagina, normal ovaries

MRKH Syndrome

DES-related T-shaped Uterus is _______ but occurs in adults exposed to DES

Rare

DES-related T-shaped Uterus Clinical S/S:

Infertility, OB loss

DES-related T-shaped Uterus USA:

Narrow, hypoplastic endometrium w/T-shape

DES-related T-shaped Uterus

Nabothian Cyst is __________ in postpartum/reproductive women

Common

Nabothian Cyst Clinical S/S:

Asymptomatic

Nabothian Cyst USA:

Small, anechoic, posterior enhancement

Nabothian Cyst

Gartner Duct Cyst is _________ but occurs in reproductive women

Rare

Gartner Duct Cyst Clinical S/S:

Asymptomatic

Gartner Duct Cyst USA:

Anechoic cyst in anterolateral vaginal wall

Gartner Duct Cyst

Cervical Stenosis is ____________but occurs in reproductive women/adolescents

Rare

Cervical Stenosis Clinical S/S:

Amenorrhea, dysmenorrhea, fluid build up

Cervical Stenosis USA:

Dilated endometrial canal, hydro, hemato, pyo metra

Cervical Stenosis

Cervical Carcinoma is________ but occurs in reproductive/postmenopausal women

Rare

Cervical Carcinoma Clinical S/S:

Postcoital bleeding, pain

Cervical Carcinoma USA:

Bulky, solid, hypervascular

May distort uterus

Cervical Carcinoma

Pelvic Congestion Syndrome is ______________ in reproductive women

Underdiagnosed

Pelvic Congestion Syndrome Clinical S/S:

Chronic pelvic pain, vericosities

Pelvic Congestion Syndrome USA:

Dilated periuterine veins, >5mm

Low velocity color flow

Pelvic Congestion Syndrome

Endometriosis is the most___________ in reproductive women

Common

Endometriosis Clinical S/S:

Dysmenorrhea, dyspareunia, infertility, elevated CA 125, positive endometrioma

Endometriosis USA:

Slide sign –

-         Good: rectum and endo move w/pressure

-         Bad: Rectum and endo do not more with pressure

Possible bilateral or unilateral ovarian cysts

Endometriosis

Endometrial Polyp is ________ in peri-post menopausal women

Common

Endometrial Polyp Clinical S/S:

Asymptomatic

• AUB

• Infertility

Endometrial Polyp USA

Focal hyperechoic area in endo, round or oval, hyperechoic endometrial mass

Color feeding stalk

Endometrial Polyp

Endometrial Hyperplasia is ___________ in peri-post menopausal women

Common

Endometrial Hyperplasia Clinical S/S:

Asymptomatic

• AUB

Endometrial Hyperplasia USA

Thickened endo

-         REPRO = 14mm

-         Post > 5mm if asymptomatic

-         Post > 8mm if symptomatic

Endometrial Hyperplasia

Endometrial Carcinoma is common in ____________ women

Postmenopausal

Endometrial Carcinoma Clinical S/S:

AUB

Endometrial Carcinoma USA:

Thick, irregular endo, focal abnormality in endometrium, distorted myometrium

Endometrial carcinoma