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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Didelphys uterus with imperforated obstructed hemivagina is a rare condition. Most often, it is diagnosed a few months after the menarche. Hematocolpos, hematometria and sometimes hematosalpinx are responsible for pelvic pain and dysmenorrhea. Symptoms can be delayed when a fistulisation from the hematocolpos to permeable contralateral vagina is present. Sometimes, diagnosis is not made before adulthood during an infection of the hematocolpos. Useful additional exams include pelvic ultrasound and, in some cases, MRI, which is the best exam to precisely describe the type of malformation. An ipsilateral agenesia of the kidney is always associated. Hysterography can usually demonstrate the fistulous courses. Treatment consists in a large resection of the vaginal septum in order to allow a permanent drainage of the hemiuterus. A laparoscopy should be performed to check for the presence of associated tubal or pelvic damage.
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PMID:[Treatment of didelphys uterus with imperforated obstructed hemivagina]. 1785 67

Acute pelvic pain in women is a routine situation in any emergency unit. The radiologist should know how to explore the patient with regards to the history and clinical findings. Ultrasonography is the primary and sometimes the only necessary imaging tool in the assessment of acute pelvic pain in women. MRI is the preferred technique in pregnant or young women. CT is more valuable for assessing nongynecologic disorders or post-partum and post-operative infections. This article reviews the contribution of each imaging technique in this clinical situation. Emphasis is put on the importance of age and clinical findings in the diagnostic strategy.
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PMID:[Imaging of acute pelvic pain in women]. 1828 36

This is a review of different diseases implicated in chronic pelvic pain (endometriosis, adenomyosis, pelvic varices, and pelvic chronic inflammatory disease) assessed by different imaging modalities (US, CT, MRI).
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PMID:[Imaging of chronic pelvis pain]. 1828 37

The role of imaging in obstetrics and gynecology has undergone a revolution over the past few decades. Well-established methods such as endovaginal ultrasound have had a central role in the evaluation of nongravid patients with pelvic pain, as well as in the workup for ectopic pregnancy and evaluation of adnexal masses. Additional tools include MRI in the evaluation of appendicitis and other potentially surgical conditions in pregnant patients and MRI and CT in the evaluation of surgical complications. Newer tools in the radiology armamentarium include PET scanning which, alongside MRI and CT, are often helpful in staging gynecologic malignancy. The role of imaging in the obstetric and gynecology patient will continue to change as new modalities and techniques are introduced.
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PMID:CT, MRI, PET, PET/CT, and ultrasound in the evaluation of obstetric and gynecologic patients. 1838 Nov 18

Pelvic pain as the presenting symptom of demyelinating disease is rare. We report on a 49-year-old female patient that initially had symptoms of pain and anesthesia in the perineum. Symptoms later evolved to include both lower and upper extremity weakness and were associated with enhancing spinal cord lesions on MRI. Recognizing that the patient's disease was localized only to the spinal cord led to an eventual serological diagnosis of neuromyelitis optica (Devic's disease), a demyelinating syndrome that is now considered distinct from multiple sclerosis and that primarily affects the spinal cord and optic nerves. Pelvic pain is an unusual first presentation of this illness. Additionally, this case illustrates the challenges of establishing a diagnosis of neuromyelitis optica. Recognizing the distinct clinical features of this rare illness, referring specifically from a spinal cord or ophthalmological etiology, is essential for its rapid diagnosis, and hence for initiation of appropriate therapy.
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PMID:Pelvic pain as an unusual first presentation of a demyelinating disease. 1876 78

Uterine artery embolization (UAE) is an effective treatment for symptomatic uterine fibroids. Magnetic resonance (MR) imaging is typically employed to evaluate the uterus following UAE for fibroid infarction, size, location change, persistent enhancement, changes in adenomyosis, and uterine necrosis. Variable pattern of calcification on computed tomography (CT) can differentiate embolic particles and fibroid involution. CT following UAE may be requested because of acute pelvic pain or chest discomfort or pyrexia and/or for complications that may require treatment in acute phase. Visualization of gas in uterus and uterine vessels following UAE is an expected finding that should not be misinterpreted as a sign of infection. The MRI and CT appearances vary depending upon the time interval after UAE and success of the procedure. Radiologists should be familiar with the range of post-UAE appearances on MRI and CT to better aid clinicians in correct diagnosis and treatment. The main purpose of this pictorial review is to identify the spectrum of findings on MRI and CT performed after UAE, to illustrate UAE-associated common and uncommon MRI and CT appearances and discuss post-UAE complications that require urgent medical or surgical intervention.
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PMID:Spectrum of imaging findings on MRI and CT after uterine artery embolization. 1904 34

Myalgias most commonly occur in polymyalgia rheumatica (PMR). About 45% of patients with giant cell arteritis present with symptoms of PMR. Other vasculitides may also lead to arthralgia and myalgia. While shoulder and pelvic pain is characteristic for PMR pain often also occurs in the back of the neck and in the region of the thoracic spine. In addition, patients often present with malaise, morning stiffness and weight loss. CRP and ESR are elevated. Ultrasound and MRI delineate minor synovitis, tenosynovitis and bursitis in the shoulder. Hip joint synovitis and trochanteric bursitis are also commonly seen. PMR should be distinguished from rheumatoid arthritis. The initial treatment comprises a prednisolone dose of 15-25 mg/day, followed by a weekly decrease of 1-2.5 mg. Once 10 mg/day has been reached the dose should be reduced more slowly.
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PMID:[Myalgia in polymyalgia rheumatica, temporal arteritis and other vasculitides]. 1958 33

Underlying adenomyosis is often the cause of treatment failure for patients undergoing Mirena insertion, endometrial ablation and/or hysteroscopic resection for abnormal uterine bleeding and/or pelvic pain. In this cohort of abnormal uterine bleeding, clinicians rarely considered adenomyosis as a differential diagnosis. In such cases, gynaecologists concentrated primarily on menstrual flow. Symptoms of pelvic pain, dyspareunia, pelvic pressure symptoms and type of dysmenorrhoea were not queried. Frequently, no correlation was sought to account for a uterus noted to be enlarged either clinically or at hysteroscopy. Given the limitation of ultrasound scan (USS) in diagnosing adenomyosis, and gynaecologists' reliance on USS findings, adenomyosis often remains undiagnosed before a hysterectomy. An earlier diagnosis of adenomyosis requires a good history, correlation of clinical examination and ultrasound scan findings and a back-up MRI service. Once adenomyosis is suspected, women can be appropriately counselled so that they are fully aware of the possible failure of conservative management. If conservative management is chosen, they should be followed-up and hysterectomy offered for persistent symptoms.
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PMID:Adenomyosis: still largely under-diagnosed. 1969 4

A 16-year-old adolescent girl presented with chronic pelvic pain. Pelvic ultrasound and MRI showing a uterus didelphys, normal left uterus and cervix, right pelvic fluid collection and right unilateral renal agenesis. After two unsuccessful vaginal surgeries for drainage of hematotrachelos and creation of an outflow tract, patient underwent unilateral total abdominal hysterectomy with final pathology confirming hematotrachelos and non-communicating cervical atresia on the right. Patient on postoperative follow-up doing well.
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PMID:Unilateral non-communicating cervical atresia in a patient with uterus didelphys and unilateral renal agenesis. 2081 28

Ultrasound should be considered the first-line imaging modality of choice in women presenting with acute or chronic pelvic pain of suspected gynecologic or obstetric origin because many, if not most, gynecologic/obstetric causes of pelvic pain are easily diagnosed on ultrasound examination. Since the clinical presentation of gynecologic causes of pelvic pain overlaps with gastrointestinal and genitourinary pathology, referral to CT or MRI, especially in pregnant patients, should be considered if the US examination is nondiagnostic.
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PMID:Ultrasound evaluation of gynecologic causes of pelvic pain. 2141 29


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