Ultrasound - Initial pelvic ultrasound
If one were to diagnose ovarian torsion, what should one look for next?
One should look for the reason for the torsion. The reason for most should be obvious... a leading mass. Ovarian tumors (benign or malignant) are involved in ~50-60% of cases of torsion, and most masses causing torsion are 4-6 cm (although torsion is possible with smaller masses).
In this set of TA and EV images, a number of findings were made
- enlarged right ovary (6.7 x 6.7 x 4.7 cm), with moderately echoic central stroma and peripheral small follicles
- left ovary is normal
- uterus is normal
- hypoechoic free fluid in the pelvis
- spectral Doppler: flow detected in both ovaries
The patient was tender to the exam with both the TA transducer and the EV probe.