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Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

22 results found
Article

Uterine restricted diffusion

Uterine restricted diffusion refers to a hyperintense signal involving the endometrium, myometrium, or cervix on DWI images with a corresponding low signal on ADC images, with a mean cut-off ADC value for malignancy of 1.15 x 10-3 mm2/s 7. Endometrial restricted diffusion malignant endometrial...
Article

Differential diagnosis for PV bleeding (non-pregnant patients)

Per vaginal (PV) bleeding in a non-pregnant patient is a common clinical presentation with a multitude of causes. The potential causes vary with the patient's menstrual status. A well-known mnemonic is found here. Premenopausal fibroids cervical cancer adenomyosis endometriosis polycystic...
Article

Endometrial fluid

Fluid in the endometrial cavity can result from a number of causes if excessive and associated with distension.  Pathology There are essentially three types of fluid:  hydrometra: simple fluid hematometra: hemorrhagic content / clot pyometra: pus Premenopausal normal (i.e. physiological) ...
Article

Valsalva maneuver

The Valsalva maneuver is the forced expiration of air against a closed airway, resulting in increased intra-abdominal, intrathoracic, and pharyngeal pressure. It can be performed against a closed glottis or by one closing the mouth and pinching the nose while forcibly exhaling. It is commonly u...
Article

Differential diagnosis of free fluid in cul de sac (pouch of Douglas)

The cul-de-sac, also known as the pouch of Douglas or rectouterine pouch, is an extension of the postero-inferior reflection of the peritoneal fold between the uterus (anteriorly) and rectum (posteriorly). It is the most inferior aspect of the peritoneal cavity and therefore the first location w...
Article

Vulval neoplasms

Vulval neoplasms are rare and mostly seen in elderly female patients. Squamous cell carcinoma (SCC) is the most common malignancy of the vulva and only 30% of them are associated with oncogenic human papillomaviruses (HPVs). Pathology Squamous neoplastic lesions  Premalignant  classic vulvar...
Article

Right iliac fossa mass (differential)

Right iliac fossa mass is a common clinical presentation and has a range of differentials that need to be excluded. Radiology plays an important role in this differentiation. Differential diagnosis appendicular mass appendicular abscess appendicular mucocele appendicular neoplasms ileoceca...
Article

Endometrial microcalcifications

Endometrial microcalcifications can arise from a vast range pathologies but are usually of benign in etiology. They can also occur in the endocervical region (see - endocervical microcalcifications 1) Epidemiology They have an increased incidence with older age, postmenopausal state, atrophic ...
Article

Infertility in the exam

It is important to have a systematic way of approaching a case with subfertility in the exam.  Ultrasound is the initial examination of choice. Always say that you would further assess the uterus with 3D ultrasound. You may also say that in my department we would perform a sonohysterogram or HS...
Article

Per vaginal bleeding in the exam

It is important to have a systematic way of approaching a case with per vaginal (PV) bleeding in the exam.  Premenopausal embedded IUCD lost IUCD submucosal fibroid Pregnancy-related perigestational hemorrhage intrauterine fetal demise ectopic pregnancy ruptured ectopic cervical ectopi...
Article

Ovarian lesions with T2 hypointensity

A hypointense ovarian lesion on T2 weighted MRI is usually a sign of benignity.  The low signal is considered to be due to fibrosis and blood products 1. Lesions that can give this appearance include 1: endometrioma Brenner tumor ovarian fibroma ovarian fibrothecoma ovarian cystadenofibrom...
Article

Epithelial ovarian tumors

Ovarian epithelial tumors account for the majority of all ovarian tumors (60-70%) and their malignant forms represent >90% of ovarian cancers 1. They can range from being benign to highly malignant. Epidemiology There is a difference in frequency of ovarian tumor subtypes depending on menopaus...
Article

Frontal bossing

Frontal bossing is a calvarial radiographic feature where the front of the skull appears protruding anteriorly. It is best appreciated on a sagittal or lateral image. Pathology This feature can be seen in many conditions (in alphabetical order): 18q syndrome acromegaly achondroplasia ß-tha...
Article

Uterine enlargement (differential)

Uterine enlargement can occur in a number of situations from both diffuse and focal processes. These include:  gestation related events normal intrauterine pregnancy molar pregnancy - gestational trophoblastic disease  postpartum uterus - still larger than usual hormonal causes exogenous h...
Article

Abnormally thickened endometrium (differential)

Abnormally thickened endometrium on imaging may occur for a number of reasons which may be categorized based on whether or not they are related to pregnancy. Etiologies may also be classified based on whether the patient is premenopausal or postmenopausal. Differential diagnosis Pregnancy-rela...
Article

Syndactyly

Syndactyly (plural: syndactylies) refers to a congenital fusion of two or more digits. It may be confined to soft tissue (soft tissue syndactyly/simple syndactyly) or may involve bone (bony syndactyly/complex syndactyly). Epidemiology The overall estimated incidence is at ~1 per 2,500 to 5,000...
Article

Placentomegaly

Placentomegaly is a term applied to an abnormally-enlarged placenta. Epidemiology Associations It can be associated with a number of maternal and fetal disorders which include: maternal maternal anemia(s) maternal diabetes chronic intrauterine infections alpha-thalassemia fetal umbilic...
Article

Cystic retroperitoneal lesions

Cystic retroperitoneal lesions can carry a relatively broad differential, which includes: retroperitoneal lymphatic malformation retroperitoneal mucinous cystadenoma retroperitoneal cystic teratoma retroperitoenal cystic mesothelioma pseudomyxoma retroperitonei with cystic change perianal ...
Article

WHO classification of uterine tumors

The World Health Organization (WHO) classification of tumors of the uterine corpus is a commonly used classification system for uterine tumors. It is part of the 5th edition WHO classification of female genital tumors, published in 2020 1.  Classification Endometrial epithelial tumors and prec...
Article

Polyhydramnios

Polyhydramnios refers to a situation where the amniotic fluid volume is more than expected for gestational age. It is generally defined as: amniotic fluid index (AFI) >25 cm largest fluid pocket depth (maximal vertical pocket (MVP)) greater than 8 cm 6 ​some centers, particularly in Australi...
Article

Pelvic masses in females

Pelvic masses in females carry a broad differential diagnosis: benign adnexal cyst leiomyoma pelvic malignancy dermoid endometriosis pelvic inflammatory disease tubo-ovarian abscess hydrosalpinx pregnancy Extragynaecological masses, e.g. colorectal carcinoma, appendicular abscess, lymp...
Article

Pyometrium

Pyometrium refers to infection of the endometrial cavity with resulting expansion due to accumulated pus (pyometra). The postmenopausal demographic are most commonly affected due to the association with uterine malignancy. Pathology Causes endometritis / pelvic inflammatory disease uterine ...

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