Endometriosis differential diagnosis: Difference between revisions
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|Endometriosis | |Endometriosis | ||
| | | | ||
*Dysmenorrhea | |||
Peak age 25 to 35 years | *Dyspareunia | ||
| | *Infertility | ||
| | *Peak age of onset 25 to 35 years of age | ||
Nodules of the rectovaginal septum | | | ||
*Nodules in the posterior fornix | |||
*Adnexal masses | |||
*Fixed retroverted uterus | |||
Laproscopic visualization | *Lateral displacement of the cervix | ||
| | |||
*IncreasedSerum cancer antigen-125 | |||
*Nodules of the rectovaginal septum and hypoechoic, vascular mass on MRI | |||
*Laproscopic visualization confirms the diagnosis | |||
|- | |- | ||
|Adenomyosis<ref name="pmid16782099">{{cite journal| author=Parker JD, Leondires M, Sinaii N, Premkumar A, Nieman LK, Stratton P| title=Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. | journal=Fertil Steril | year= 2006 | volume= 86 | issue= 3 | pages= 711-5 | pmid=16782099 | doi=10.1016/j.fertnstert.2006.01.030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16782099 }}</ref> | |Adenomyosis<ref name="pmid16782099">{{cite journal| author=Parker JD, Leondires M, Sinaii N, Premkumar A, Nieman LK, Stratton P| title=Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. | journal=Fertil Steril | year= 2006 | volume= 86 | issue= 3 | pages= 711-5 | pmid=16782099 | doi=10.1016/j.fertnstert.2006.01.030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16782099 }}</ref> | ||
|Abnormal uterine bleeding | | | ||
*Abnormal uterine bleeding | |||
40 and | *Dysmenorrhea | ||
*Peak age of onset 40 and 50 years of age | |||
|Diffuse uterine enlargement always less than size corresponding to less than 12 weeks of gestation | |Diffuse uterine enlargement always less than size corresponding to less than 12 weeks of gestation | ||
|Asymmetric thickening of the myometrium on MRI | | | ||
*Asymmetric thickening of the myometrium on MRI | |||
|- | |- | ||
|Submucous uterine leiomyomas<ref name="pmid26477496">{{cite journal| author=Donnez J, Donnez O, Matule D, Ahrendt HJ, Hudecek R, Zatik J et al.| title=Long-term medical management of uterine fibroids with ulipristal acetate. | journal=Fertil Steril | year= 2016 | volume= 105 | issue= 1 | pages= 165-173.e4 | pmid=26477496 | doi=10.1016/j.fertnstert.2015.09.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26477496 }}</ref> | |Submucous uterine leiomyomas<ref name="pmid26477496">{{cite journal| author=Donnez J, Donnez O, Matule D, Ahrendt HJ, Hudecek R, Zatik J et al.| title=Long-term medical management of uterine fibroids with ulipristal acetate. | journal=Fertil Steril | year= 2016 | volume= 105 | issue= 1 | pages= 165-173.e4 | pmid=26477496 | doi=10.1016/j.fertnstert.2015.09.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26477496 }}</ref> | ||
| | | | ||
*Menorrhagia | |||
Menorrhagia | *Pelvic pressure and pain | ||
*Infertility | |||
Pelvic pressure and pain | *Peak age of onset 25 to 44 years of age | ||
| | |||
*Mobile uterus with an irregular contour | |||
| | | | ||
|Transvaginal ultrasound will demonstrate the presence of myomas | *Transvaginal ultrasound will demonstrate the presence of myomas | ||
|- | |- | ||
|Pelvic Inflammatory disease<ref name="pmid24216035">{{cite journal| author=Ross J, Judlin P, Jensen J, International Union against sexually transmitted infections| title=2012 European guideline for the management of pelvic inflammatory disease. | journal=Int J STD AIDS | year= 2014 | volume= 25 | issue= 1 | pages= 1-7 | pmid=24216035 | doi=10.1177/0956462413498714 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24216035 }}</ref> | |Pelvic Inflammatory disease<ref name="pmid24216035">{{cite journal| author=Ross J, Judlin P, Jensen J, International Union against sexually transmitted infections| title=2012 European guideline for the management of pelvic inflammatory disease. | journal=Int J STD AIDS | year= 2014 | volume= 25 | issue= 1 | pages= 1-7 | pmid=24216035 | doi=10.1177/0956462413498714 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24216035 }}</ref> | ||
| | | | ||
*Seen in patients with history of sexually transmitted disease | |||
multiple sexual partners | *History of multiple sexual partners | ||
*Common in women younger than 25 years of age | |||
| | |||
| | *Abdominal tenderness | ||
*Acute cervical motion, uterine, and adnexal tenderness | |||
Acute cervical motion, uterine, and adnexal tenderness | *Visualization of urulent endocervical discharge | ||
| | |||
*Positive Nucleic acid amplification tests for C. trachomatis and N. gonorrhoeae | |||
|Positive Nucleic acid amplification tests | *Gram negative diplococci on gram stain | ||
|- | |- | ||
|Pelvic congestion Syndrome<ref name="pmid11133549">{{cite journal| author=Rozenblit AM, Ricci ZJ, Tuvia J, Amis ES| title=Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. | journal=AJR Am J Roentgenol | year= 2001 | volume= 176 | issue= 1 | pages= 119-22 | pmid=11133549 | doi=10.2214/ajr.176.1.1760119 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11133549 }}</ref> | |Pelvic congestion Syndrome<ref name="pmid11133549">{{cite journal| author=Rozenblit AM, Ricci ZJ, Tuvia J, Amis ES| title=Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. | journal=AJR Am J Roentgenol | year= 2001 | volume= 176 | issue= 1 | pages= 119-22 | pmid=11133549 | doi=10.2214/ajr.176.1.1760119 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11133549 }}</ref> | ||
| | | | ||
|Bimanual tenderness | *Shifting lower abdominal pain | ||
Cervical motion tenderness | *Deep dyspareunia | ||
| | *Post-coital pain | ||
*Exacerbation of pain after prolonged standing | |||
| | |||
*Bimanual tenderness | |||
*Cervical motion tenderness | |||
| | |||
*Pelvic varicosities on ultrasound with reduced blood flow | |||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 16:05, 16 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
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 | |
---|---|---|---|
Endometriosis |
|
|
|
Adenomyosis[1] |
|
Diffuse uterine enlargement always less than size corresponding to less than 12 weeks of gestation |
|
Submucous uterine leiomyomas[2] |
|
|
|
Pelvic Inflammatory disease[3] |
|
|
|
Pelvic congestion Syndrome[4] |
|
|
|
References
- ↑ Parker JD, Leondires M, Sinaii N, Premkumar A, Nieman LK, Stratton P (2006). "Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis". Fertil Steril. 86 (3): 711–5. doi:10.1016/j.fertnstert.2006.01.030. PMID 16782099.
- ↑ Donnez J, Donnez O, Matule D, Ahrendt HJ, Hudecek R, Zatik J; et al. (2016). "Long-term medical management of uterine fibroids with ulipristal acetate". Fertil Steril. 105 (1): 165–173.e4. doi:10.1016/j.fertnstert.2015.09.032. PMID 26477496.
- ↑ Ross J, Judlin P, Jensen J, International Union against sexually transmitted infections (2014). "2012 European guideline for the management of pelvic inflammatory disease". Int J STD AIDS. 25 (1): 1–7. doi:10.1177/0956462413498714. PMID 24216035.
- ↑ Rozenblit AM, Ricci ZJ, Tuvia J, Amis ES (2001). "Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women". AJR Am J Roentgenol. 176 (1): 119–22. doi:10.2214/ajr.176.1.1760119. PMID 11133549.