4.4 Review

Imaging of acute pelvic pain

Journal

BRITISH JOURNAL OF RADIOLOGY
Volume 94, Issue 1127, Pages -

Publisher

BRITISH INST RADIOLOGY
DOI: 10.1259/bjr.20210281

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Acute pelvic pain requires urgent medical evaluation and the differential diagnosis is broad, including various gynecologic and non-gynecologic causes. Imaging, particularly ultrasound and CT, plays a crucial role in the fast and accurate diagnosis of APP. Radiologists need to be familiar with the possible causes and choose the best imaging strategy based on clinical presentation and laboratory findings to establish a fast and accurate diagnosis.
Acute pelvic pain (APP) requires urgent medical evaluation and treatment. Differential diagnosis of APP is broad, including a variety of gynecologic and non-gynecologic/ urinary, gastrointestinal, vascular and other entities. Close anatomical and physiological relations of pelvic structures, together with similar clinical presentation of different disorders and overlapping of symptoms, especially in the emergency background, make the proper diagnosis of APP challenging. Imaging plays a crucial role in the fast and precise diagnosis of APP. Ultrasonography is the first line imaging modality, often accompanied by CT, while MRI is utilized in specific cases, using short, tailored protocols. Recognizing the cause of APP in females is a challenging task, due to the wide spectrum of possible origin and overlap of their imaging features. Therefore, the radiologist has to be familiar with the possible causes of APP, and, relying on clinical presentation, together with laboratory findings, choose the best imaging strategy in order to establish a fast and accurate diagnosis.

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