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.