Differential Diagnosis for Pelvic Ultrasound Findings
Single Most Likely Diagnosis
- Septate Uterus with Intramural Fibroid: This diagnosis is the most likely given the ultrasound findings directly describe a septate uterus and a small intramural fibroid. The presence of these conditions can explain the symptoms and ultrasound findings.
Other Likely Diagnoses
- Endometriosis: Given the presence of a tender but mobile and normal-appearing right ovary, endometriosis could be a consideration, especially if the patient presents with symptoms such as pelvic pain or infertility.
- Adenomyosis: Although not directly mentioned, the presence of an intramural fibroid and a septate uterus might suggest the possibility of adenomyosis, particularly if the patient experiences heavy menstrual bleeding or pelvic pain.
Do Not Miss Diagnoses
- Ovarian Torsion: Although the ovary is described as mobile and normal-appearing, ovarian torsion is a medical emergency that must be considered, especially if there's any suspicion of acute pelvic pain or if the patient's condition changes.
- Ectopic Pregnancy: In any female patient of reproductive age presenting with pelvic pain or abnormalities, ectopic pregnancy must be ruled out due to its potential for severe consequences.
Rare Diagnoses
- Uterine Anomalies Other Than Septate Uterus: While a septate uterus is identified, other uterine anomalies (like bicornuate, unicornuate, or didelphic uterus) could potentially present with similar symptoms or findings, although they are less common.
- Malignant Transformation of Fibroid: Although rare, there's a possibility, however small, of malignant transformation of a fibroid (leiomyosarcoma), which would significantly alter the management and prognosis.