Gynecological ultrasound set-pieces

The clinical history will nearly always lead to a short differential or the answer. Show off to the examiner that you have a structured approach to reporting and managing the patient.

Structured approach

  • uterus: size, version and shape (normal or variant which you should elaborate on and say what it most likely is e.g. arcuate, septate, bicornuate and state that you would always perform a 3D ultrasound to evaluate it)
  • endometrium: thickness and phase in the menstrual cycle (thin with oral contraceptive pill (OCP))
  • myometrium:  normal, focal thickness or abnormality, generalized thickness
  • serosa: normal or fibroid
  • ovaries: normal, cystic or mass
  • pelvic fluid: not present, small or large volume, sonolucent or echogenic

Normal example: transabdominal and transvaginal pelvic images demonstrate a normal uterus that is anteverted/retroverted and measures 80 x 35 x 50 mm. The endometrium has a normal thickness of 3 mm, normal vascularity and is in the menstrual/proliferative or secretory phase. The myometrium and serosa have a normal appearance. Both ovaries have a normal size and appearance and there is a trace of fluid in the pouch of Douglas.

Clinical history

Article information

rID: 22718
System: Gynaecology
Section: Approach
Synonyms or Alternate Spellings:

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Cases and figures

  • Case 1: uterus volume measurement
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  • Case 1: uterus longitudinal view
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  • Case 1: uterus transverse view
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  • Case 1: endometrium thickness
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  • Case 1: ovary volume measurement
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