From the Guidelines
Mild pelvic prominence on imaging typically does not require further investigation or intervention if it is the only finding and there are no associated symptoms, as it often represents an incidental anatomical variation that falls within the spectrum of normal 1. This approach prioritizes the patient's morbidity, mortality, and quality of life by avoiding unnecessary interventions and their potential risks. The key determinant for further action is whether the patient has any clinical symptoms that correlate with this radiographic finding.
Clinical Considerations
If the patient is experiencing symptoms such as pain, discomfort, or functional limitations, then follow-up with their healthcare provider would be appropriate. Pelvic prominences can sometimes represent normal developmental variations in bone structure, particularly at the iliac crests or pubic symphysis. The presence of symptoms would necessitate a more thorough evaluation, potentially including further imaging or other diagnostic tests to determine the cause of the symptoms.
Imaging and Diagnostic Tests
Imaging tests such as fluoroscopy, MRI, and ultrasound (US) provide global information about the pelvic floor and may be of particular benefit in areas where clinical evaluation is limited 1. However, for asymptomatic patients with mild pelvic prominence, these tests are not initially recommended unless there are other indications or symptoms suggestive of pelvic floor dysfunction.
Management Approach
If the imaging was done for an unrelated reason and the patient is asymptomatic, watchful waiting is generally sufficient. However, if the patient develops new symptoms like pain in the pelvic region, changes in urinary or bowel habits, or difficulty with movement, they should promptly consult their healthcare provider for reassessment 1. It's also important to note that radiologists often note minor anatomical variations that require no intervention but are documented for completeness.
Advanced Diagnostic Techniques
For patients with defecatory dysfunction, MR defecography with rectal contrast is one of the initial imaging tests of choice and can confirm suspected structural and functional abnormalities, such as rectal intussusception or prolapse, rectocele, and pelvic floor dyssynergia 1. This highlights the importance of selecting the appropriate diagnostic test based on the patient's symptoms and clinical presentation.
From the Research
Mild Pelvic Prominence Investigation
- In the context of otherwise normal imaging results, mild pelvic prominence may not necessarily require further investigation or intervention 2.
- The decision to pursue further evaluation depends on the presence of other clinical symptoms or abnormal imaging findings 3, 4.
- A compartmental approach to imaging the pelvis can help identify and characterize masses or abnormalities, guiding the need for additional workup 4.
- Classic findings in pelvic MRI can aid in diagnosing common conditions, but may not directly address mild pelvic prominence 5.
- In adolescent females, MR imaging can be useful in evaluating the pelvis, particularly for characterizing masses or congenital anomalies, but its role in mild pelvic prominence is not explicitly stated 6.