Endometriosis differential diagnosis: Difference between revisions
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*Pelvic [[varicosities]] on ultrasound with reduced blood flow | *Pelvic [[varicosities]] on ultrasound with reduced blood flow | ||
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! style="background: #4479BA; width: 180px;" | {{fontcolor|#000|Disease}} | |||
! style="background: #4479BA; width: 650px;" | {{fontcolor|#000|Findings}} | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''[[Ectopic pregnancy]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" | History of missed menses, positive [[pregnancy test]], [[ultrasound]] reveals an empty [[uterus]] and may show a mass in the [[fallopian tubes]].<ref name="pmid27720100">{{cite journal |vauthors=Morin L, Cargill YM, Glanc P |title=Ultrasound Evaluation of First Trimester Complications of Pregnancy |journal=J Obstet Gynaecol Can |volume=38 |issue=10 |pages=982–988 |year=2016 |pmid=27720100 |doi=10.1016/j.jogc.2016.06.001 |url=}}</ref> | |||
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| style="padding: 7px 7px; background: #DCDCDC;" |'''[[Appendicitis]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Pain localized to the [[right iliac fossa]], [[vomiting]], [[Ultrasound|abdominal ultrasound]] [[Sensitivity (tests)|sensitivity]] for diagnosis of [[acute appendicitis]] is 75% to 90%.<ref name="pmid8259423">{{cite journal |vauthors=Balthazar EJ, Birnbaum BA, Yee J, Megibow AJ, Roshkow J, Gray C |title=Acute appendicitis: CT and US correlation in 100 patients |journal=Radiology |volume=190 |issue=1 |pages=31–5 |year=1994 |pmid=8259423 |doi=10.1148/radiology.190.1.8259423 |url=}}</ref> | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''Ruptured[[ ovarian cyst]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Usually spontaneous, can follow history of trauma; mild chronic lower abdominal discomfort may suddenly intensify, [[ultrasound]] is diagnostic.<ref name="pmid19299205">{{cite journal |vauthors=Bottomley C, Bourne T |title=Diagnosis and management of ovarian cyst accidents |journal=Best Pract Res Clin Obstet Gynaecol |volume=23 |issue=5 |pages=711–24 |year=2009 |pmid=19299205 |doi=10.1016/j.bpobgyn.2009.02.001 |url=}}</ref> | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''[[Ovarian cyst ]]torsion''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Present with acute severe unilateral [[Lower abdominal pain|lower quadrant abdominal pain]], [[nausea and vomiting]], tender adnexal mass palpated in 90%, [[ultrasound]] is diagnostic.<ref name="pmid26760839">{{cite journal |vauthors=Bhavsar AK, Gelner EJ, Shorma T |title=Common Questions About the Evaluation of Acute Pelvic Pain |journal=Am Fam Physician |volume=93 |issue=1 |pages=41–8 |year=2016 |pmid=26760839 |doi= |url=}}</ref> | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''Hemorrhagic [[ovarian cyst]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Presents with [[Abdominal pain|localized abdominal pain]], [[nausea and vomiting]]. [[Hypovolemic shock]] may be present; [[abdominal tenderness]] and guarding are physical exam findings, [[ultrasound]] is diagnostic.<ref name="pmid26760839">{{cite journal |vauthors=Bhavsar AK, Gelner EJ, Shorma T |title=Common Questions About the Evaluation of Acute Pelvic Pain |journal=Am Fam Physician |volume=93 |issue=1 |pages=41–8 |year=2016 |pmid=26760839 |doi= |url=}}</ref> | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''[[Endometriosis]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Present with cyclic pain that is exacerbated by onset of menses and during the [[luteal phase]]; [[dyspareunia]], [[transvaginal ultrasound]] is suggestive, [[Laparoscopy|laparoscopic]] exploration is diagnostic.<ref name="pmid26760839">{{cite journal |vauthors=Bhavsar AK, Gelner EJ, Shorma T |title=Common Questions About the Evaluation of Acute Pelvic Pain |journal=Am Fam Physician |volume=93 |issue=1 |pages=41–8 |year=2016 |pmid=26760839 |doi= |url=}}</ref> | |||
|- | |||
| style="padding: 7px 7px; background: #DCDCDC;" | '''[[Diverticulitis]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Present with bowel symptoms in older women | |||
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| style="padding: 7px 7px; background: #DCDCDC;" | '''[[Acute cystitis]]''' | |||
| style="padding: 7px 7px; background: #F5F5F5;" |Features with increased [[frequency]] and [[urgency]], [[dysuria]], and suprapubic pain.<ref>{{Cite journal | |||
| author = [[W. E. Stamm]] | |||
| title = Etiology and management of the acute urethral syndrome | |||
| journal = [[Sexually transmitted diseases]] | |||
| volume = 8 | |||
| issue = 3 | |||
| pages = 235–238 | |||
| year = 1981 | |||
| month = July-September | |||
| pmid = 7292216 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[W. E. Stamm]], [[K. F. Wagner]], [[R. Amsel]], [[E. R. Alexander]], [[M. Turck]], [[G. W. Counts]] & [[K. K. Holmes]] | |||
| title = Causes of the acute urethral syndrome in women | |||
| journal = [[The New England journal of medicine]] | |||
| volume = 303 | |||
| issue = 8 | |||
| pages = 409–415 | |||
| year = 1980 | |||
| month = August | |||
| doi = 10.1056/NEJM198008213030801 | |||
| pmid = 6993946 | |||
}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 16:56, 20 June 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Endometriosis is a cause of dysmenorrhea and dyspareunia, it must be differentiated from other conditions presenting with similar features such as adenomyosis, pelvic inflammatory disease, pelvic congestion syndrome and sub mucosal uterine fibroids.
Differential Diagnosis
Endometriosis is a cause of abnormal uterine bleeding and can result in infertility. There are several diseases which can result in excessive uterine bleeding and the following table is a description of various causes of excessive uterine bleeding.
Clinical Features | Physical Examination | Diagnostic Findings | |
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Endometriosis |
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Adenomyosis[1] |
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Submucous uterine leiomyomas[2] |
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Pelvic Inflammatory disease[3] |
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Pelvic congestion Syndrome[4] |
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Disease | Findings |
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Ectopic pregnancy | History of missed menses, positive pregnancy test, ultrasound reveals an empty uterus and may show a mass in the fallopian tubes.[5] |
Appendicitis | Pain localized to the right iliac fossa, vomiting, abdominal ultrasound sensitivity for diagnosis of acute appendicitis is 75% to 90%.[6] |
Rupturedovarian cyst | Usually spontaneous, can follow history of trauma; mild chronic lower abdominal discomfort may suddenly intensify, ultrasound is diagnostic.[7] |
Ovarian cyst torsion | Present with acute severe unilateral lower quadrant abdominal pain, nausea and vomiting, tender adnexal mass palpated in 90%, ultrasound is diagnostic.[8] |
Hemorrhagic ovarian cyst | Presents with localized abdominal pain, nausea and vomiting. Hypovolemic shock may be present; abdominal tenderness and guarding are physical exam findings, ultrasound is diagnostic.[8] |
Endometriosis | Present with cyclic pain that is exacerbated by onset of menses and during the luteal phase; dyspareunia, transvaginal ultrasound is suggestive, laparoscopic exploration is diagnostic.[8] |
Diverticulitis | Present with bowel symptoms in older women |
Acute cystitis | Features with increased frequency and urgency, dysuria, and suprapubic pain.[9][10]
References
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