Case contributed by Dr Aws Qahtan Hamdi


Severe lower abdominal pain and heavy menometrorrhagia.

Patient Data

Age: 40 years
Gender: Female

Trans-abdominal ultrasound


Trans-abdominal ultrasound shows an asymmetrical enlargement of the uterus with multiple sub-endometrial hyperechoic linear striations and/or nodules extending from the endometrium into the inner myometrium.

Irregular endometrial-myometrial junction.

Multiple sub-endometrial cysts.

Increased vascularity on color Doppler study.

Case Discussion

Adenomyosis is a common uterine condition of ectopic endometrial tissue into the myometrium, sometimes considered a spectrum of endometriosis. It may present with menorrhagia and dysmenorrhea, It usually affects the multiparous women of reproductive age. Ultrasound is the primary imaging modality for diagnosis and sensitivity is operator- and technique-dependent. Adenomyosis may be focal or diffuse form. Differential diagnoses includes uterine fibroids.


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