Differential Diagnosis
- Single most likely diagnosis
- Normal pelvic anatomy and physiology: The ultrasound findings are consistent with a normal female pelvic anatomy, with no evidence of acute or chronic pathology. The presence of simple nabothian cysts, follicles in the ovaries, and mildly prominent pelvic vessels are all within normal limits.
- Other Likely diagnoses
- Benign ovarian cysts: The presence of follicles in the ovaries and the normal size of the ovaries suggest that any cysts present are likely benign and functional.
- Cervical nabothian cysts: The ultrasound findings confirm the presence of simple appearing nabothian cysts in the cervix, which are a common and benign finding.
- Pelvic venous congestion: The mildly prominent pelvic vessels in the adnexa bilaterally may suggest pelvic venous congestion, which can be a cause of chronic pelvic pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ovarian torsion: Although the ovaries appear normal in size and shape, ovarian torsion can occur without significant changes in ovarian size or shape. The presence of vessels measuring up to 7-8 mm in diameter on the left side could be a sign of ovarian torsion.
- Ectopic pregnancy: Although the ultrasound findings do not suggest an ectopic pregnancy, it is a critical diagnosis to consider in any female patient of childbearing age presenting with pelvic symptoms.
- Malignant ovarian tumor: Although the ovaries appear normal in size and shape, it is possible that a malignant tumor could be present without significant changes in ovarian size or shape.
- Rare diagnoses
- Ovarian vein thrombosis: The presence of mildly prominent pelvic vessels in the adnexa bilaterally could suggest ovarian vein thrombosis, although this is a rare condition.
- Adnexal tumor: Although the ultrasound findings do not suggest an adnexal mass, it is possible that a rare tumor such as a parasitic myoma or a cystic teratoma could be present without significant changes in adnexal size or shape.