症例 challenge · Imaging / Gynecology / Ultrasound · teaching

Adnexal Torsion Imaging Diagnosis · case challenge

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Case #1Imaging / Gynecology / Ultrasound

📋 Case data

Acute pelvic pain · torsion signsOnly non-specific signs, but high clinical suspicion

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Step 1 / 1 · Acute pelvic pain · torsion signs

Acute pelvic pain — specific torsion signs?

💡 Adnexal/ovarian torsion, US preferred. Non-specific: enlarged ovary, abnormal position, hemorrhagic cyst/lead point, pelvic fluid. Specific signs in order of appearance: 1) twisted pedicle whirlpool/target sign (most specific, seen throughout); 2) follicular ring sign (thickened hyperechoic follicle walls 1–2 mm, early); 3) stromal edema + peripheral displacement of follicles; 4) absent Doppler flow (late). Note: normal flow does not exclude torsion (dual blood supply/intermittent).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.