The Role of Ultrasound in the Diagnosis of Pelvic Pain in Non-Pregnant Females: Role of Ultrasound in the Diagnosis of Pelvic Pain

Noor  Fatima; Gull E  Hina; Ayesha  Imran; Quratulain  Khalid

doi:10.54393/pbmj.v5i11.823

Authors

Noor Fatima Gujranwala Institute of Medical and Emerging Sciences, Gujranwala, Pakistan
Gull E Hina Gujranwala Institute of Medical and Emerging Sciences, Gujranwala, Pakistan
Ayesha Imran Gujranwala Institute of Medical and Emerging Sciences, Gujranwala, Pakistan
Quratulain Khalid Gujranwala Institute of Medical and Emerging Sciences, Gujranwala, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i11.823

Keywords:

Acute pelvic pain, non-pregnant females, PID, Ultrasound

Abstract

Pelvic pain is the most common concern among women who visit the ER, and ultrasonography should be the first imaging method used to evaluate these patients. Objectives: To evaluate how well ultrasonography could diagnose different causes that can lead to pelvic pain in women. Methods: A cross-sectional study was held at Chatha Hospital, Al Amin Diagnostic Center, and Gondal Hospital. It used B mode ultrasonographic capability and in order to avoid artifacts or attenuation, an ultrasonic gel is applied to the transducer. Hospitals were legally authorized to take the information. Inclusion criteria were used to determine patient eligibility. Results: The commonest ultrasonography findings of pelvic pain were an ovarian cyst in 16 out of 97 which were 16.4%, bulky uterus with fibroid in 26 patients (26.8%), endometriosis in 4 patients (4.1%), ovarian enlargement in 3 patients (3.1%), endometriotic cyst in 6 patients (6.2%), RPCOs in 8 patients (8.2%), PCOs in 9 patients (9.3%), hydronephrosis in 4 patients (4.1%), fluid in cul de sac in 7 patients (7.2%), thickened endometrium in 3 patients (3.1%), pelvic inflammatory disease in 5 patients (5.2%), appendicitis in 4 patients (4.1%), and inguinal hernia in 2 patients (2.1%). Conclusions: Ultrasound scanning is a critical modality for detecting pelvic changes in female patients. The most common cause of pelvic in females is uterine fibroid and ovarian cyst. Moreover, pelvic pain occurs most frequently during the reproductive age and less frequently during menopause

References

Patel MD, Young SW, Dahiya N. Ultrasound of pelvic pain in the nonpregnant woman. Radiologic Clinics. 2019 May; 57(3):601-16. doi: 10.1016/j.rcl.2019.01.010

Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014 Apr; 17(2):E141-7. doi: 10.36076/ppj.2014/17/e141

Klock S. Psychosomatic issues in obstetrics and gynecology. Gynecology principles and practice. Mosby, St Louis. 1995: 399-402.

Miller J, Cho J, Michael MJ, Saouaf R, Towfigh S. Role of imaging in the diagnosis of occult hernias. JAMA Surgery. 2014 Oct; 149(10):1077-80. doi: 10.1001/jamasurg.2014.484

Bektaş H, Bilsel Y, Sari YS, Ersöz F, Koç O, Deniz M, et al. Abdominal wall endometrioma; a 10-year experience and brief review of the literature. Journal of Surgical Research. 2010 Nov; 164(1):e77-81. doi: 10.1016/j.jss.2010.07.043

Norwitz ER and Schorge JO. Obstetrics and Gynecology at a Glance. John Wiley & Sons. 2013 Oct.

Wolfman W, Leyland N, Heywood M, Singh SS, Rittenberg DA, Soucy R, et al. Asymptomatic endometrial thickening. Journal of Obstetrics and Gynaecology Canada. 2010 Oct; 32(10):990-9. doi: 10.1016/s1701-2163(16)34690-4

Matulonis UA, Sood AK, Fallowfield L, Howitt BE, Sehouli J, Karlan BY. Ovarian cancer. Nature reviews Disease primers. 2016 Aug; 2(1):1-22. doi: 10.1038/nrdp.2016.61

Kruszka P and Kruszka SJ. Evaluation of acute pelvic pain in women. American family physician. 2010 Jul; 82(2):141-7.

Uduma FU, Ezirim TE, Ukamaka I, Udoh I, Eyo C, Aisha U. Re-emphasis on Imaging of Acute Abdomen in Surgical and Gynaecological Practice with Pictorial Depictions: A Review. BJAST. 2015; 8(1):1-9. doi: 10.9734/bjast/2015/13288

Masselli G, Brunelli R, Monti R, Guida M, Laghi F, Casciani E, et al. Imaging for acute pelvic pain in pregnancy. Insights Imaging. 2014 Apr; 5(2):165-81. doi: 10.1007/s13244-014-0314-8

Masselli G, Derchi L, McHugo J, Rockall A, Vock P, Weston M, et al. Acute abdominal and pelvic pain in pregnancy: ESUR recommendations. European Radiology. 2013 Dec; 23(12):3485-500. doi: 10.1007/s00330-013-2987-7

Abou-Elkacem L, Bachawal SV, Willmann JK. Ultrasound molecular imaging: Moving toward clinical translation. European Journal of Radiology. 2015 Sep; 84(9):1685-93. doi: 10.1016/j.ejrad.2015.03.016

Caruso M, Dell'Aversano Orabona G, Di Serafino M, Iacobellis F, Verde F, Grimaldi D, et al. Role of Ultrasound in the Assessment and Differential Diagnosis of Pelvic Pain in Pregnancy. Diagnostics. 2022 Mar; 12(3):640. doi: 10.3390/diagnostics12030640

Fakoya FA, du Plessis M, Gbenimacho IB. Ultrasound and stethoscope as tools in medical education and practice: considerations for the archives. Advances in Medical Education and Practice. 2016 Jul; 7:381-7. doi: 10.2147/AMEP.S99740

Sheeran PS, Luois S, Dayton PA, Matsunaga TO. Formulation and acoustic studies of a new phase-shift agent for diagnostic and therapeutic ultrasound. Langmuir. 2011 Sep; 27(17):10412-20. doi: 10.1021/la2013705

Chamié LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics. 2011 Aug; 31(4):E77-100. doi: 10.1148/rg.314105193

Yitta S, Mausner EV, Kim A, Kim D, Babb JS, Hecht EM, et al. Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary? Emergency Radiology. 2011 Oct; 18(5):371-80. doi: 10.1007/s10140-011-0962-7

Wallace GW, Davis MA, Semelka RC, Fielding JR. Imaging the pregnant patient with abdominal pain. Abdominal Radiology. 2012 Oct;37(5):849-60. doi: 10.1007/s00261-011-9827-5

Abramowicz JS. Benefits and risks of ultrasound in pregnancy. Seminars in Perinatology. 2013 Oct; 37(5):295-300. doi: 10.1053/j.semperi.2013.06.004

Park SB, Han BH, Lee YH. Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period. Medical Ultrasonography. 2017 Apr; 19(2):218-223. doi: 10.11152/mu-929

Nisenblat V, Prentice L, Bossuyt PM, Farquhar C, Hull ML, Johnson N. Combination of the non-invasive tests for the diagnosis of endometriosis. Cochrane Database of Systematic Reviews. 2016 Jul; 7(7):CD012281. doi: 10.1002/14651858.CD012281

Vandermeer FQ and Wong-You-Cheong JJ. Imaging of acute pelvic pain. Clinical Obstetrics and Gynecology. 2009 Mar; 52(1):2-20. doi: 10.1097/GRF.0b013e3181958173

Mazzei MA, Guerrini S, Cioffi Squitieri N, Cagini L, Macarini L, Coppolino F, et al. The role of US examination in the management of acute abdomen. Critical Ultrasound Journal. 2013 Dec; 5(1):1-9. doi: 10.1186/2036-7902-5-S1-S6.