Transvaginal pelvis ultrasound was performed, demonstrating:
- enlarged left ovary that is very tender to ultrasound probe palpation
- large anechoic cyst on the left ovary
- no vascular flow in the left ovary
- normal sized, non-tender right ovary with > 18 follicles
- anteverted, mobile, non-tender uterus with normal appearance of the endometrium
These ultrasound findings are consistent with left ovarian torsion. The patient was referred urgently to the Gynaecology unit.