The cogwheel sign refers to the pelvic imaging appearance of dilated loops of fallopian tube seen in cross-section. It represents infolding projections (sometimes looking like nodules) into the fallopian tube lumen which are likened to that of a cogwheel. The sign is typically described on ultrasound and is suggestive of tubal inflammation in pelvic inflammatory disease with a pyosalpinx or a hydrosalpinx.
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