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feat(docs): add new article on Acute Adnexal Torsion with comprehensive imaging, pathology, and clinical information
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title: "Acute Adnexal Torsion"
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---
## KEY FACTS
- ### Terminology
- Adnexal torsion is more accurate term than ovarian torsion, as torsion usually also includes fallopian tube
- ### Imaging
- Enlarged ovary: > 4 cm in longest dimension or > 20 cm³ in volume
- Ultrasound
- Enlarged, heterogeneously echogenic ovarian stroma
- Multiple small, peripheral, fluid-filled follicles displaced due to edematous stroma &/or mass
- Whirlpool sign: Coiled, twisted pedicle
- Flow pattern depends on degree of vascular obstruction and chronicity of torsion
- Venous flow initially affected
- CT
- Twisted pedicle most specific sign but seen in < 1/3 of cases (use multiplanar reformations)
- Heterogeneous, minimal, or absent enhancement indicates evolution from ischemia to infarction
- ### Top Differential Diagnoses
- Hemorrhagic corpus luteum
- Pelvic inflammatory disease
- Ectopic pregnancy
- ### Pathology
- In adults, 50-90% have associated ovarian mass that serves as lead point
- Large, physiologic follicular cyst or corpus luteum cyst most common, followed by dermoid
- Presence of venous flow indicates viable ovary
- ### Diagnostic Checklist
- Presence of normal blood flow does **not** exclude torsion
- Always look for underlying mass
## TERMINOLOGY
- ### Synonyms
- Ovarian torsion
- Adnexal torsion is preferred term, as torsion usually also involves both ovary and fallopian tube
- Isolated fallopian tube torsion may also rarely occur
- ### Definitions
- Rotation of ovary &/or fallopian tube on its vascular pedicle → vascular compromise and ultimately ovarian infarction
## IMAGING
- ### General Features
- #### Best diagnostic clue
- Enlarged, echogenic ovary with prominent peripherally displaced follicles
- Twisted vascular pedicle
- #### Location
- Midline or superior displacement of affected ovary
- Uterine deviation to side of twist
- #### Size
- Torsed ovary is enlarged, measuring > 4 cm in longest dimension or > 20 cm³ in volume
- > 10 cm³ in postmenopausal women
- Volume of torsed ovary averages 28x normal
- #### Morphology
- Swollen rounded contour of affected ovary
- In up to 90% of cases, underlying ovarian mass serves as lead point for torsion, particularly if > 5 cm
- ### Ultrasonographic Findings
- #### Grayscale ultrasound
- Enlarged, heterogeneous ovarian stroma
- Multiple small, peripheral, fluid-filled follicles displaced due to edematous, hypoechoic stroma &/or mass
- 1- to 2-mm thick, hyperechoic rim surrounding displaced follicles, known as follicular ring sign
- Cyst may be present and is frequently thick walled
- Ovary is tender to touch by US probe
- Pelvic free fluid; low-level echoes indicate hemoperitoneum
- Twisted vascular pedicle (broad ligament, fallopian tube, ovarian vessels)
- Target sign: Round, hyperechoic structure; multiple hypoechoic, concentric stripes
- Beaked structure: Twisted fallopian tube
- Heterogeneous, tubular structure: Edematous fallopian tube
- #### Pulsed Doppler
- Flow pattern depends on degree of vascular obstruction and chronicity of torsion
- Normal arterial and venous waveforms may be present, especially in acute torsion
- May also be seen with incomplete (< 360°) twist
- Venous flow affected first
- Due to dual arterial blood supply to ovary, arterial flow may be preserved
- Resistive indices may be elevated
- Absent venous and arterial flow in late torsion/ovarian infarction
- #### Color Doppler
- Twisted pedicle results in whirlpool sign
- ### CT Findings
- #### NECT
- Ovarian hematoma/hematosalpinx best seen (> 50 HU)
- #### CECT
- Enlarged, displaced ovary
- Use multiplanar reformations to better appreciate twisted pedicle
- Most specific sign but only seen in < 1/3 of cases
- Deviation of uterus toward side of torsion
- Edematous stroma hypodense with peripherally placed follicles
- Heterogeneous, minimal, or absent enhancement indicates evolution from ischemia to infarction
- Normal CT results have high negative predictive value when both ovaries are visualized
- ### MR Findings
- #### T1WI
- Hypointense ovarian edema
- Hyperintensity indicates hemorrhagic stromal infarction or hemorrhagic cyst
- Look for hyperintense rim typical of subacute hematoma
- Hyperintense fallopian tube/vascular pedicle (hemorrhage)
- #### T2WI
- Small, peripheral follicles with background of increased ovarian stromal signal intensity
- #### DWI
- Ovarian stroma in adnexal torsion exhibit strong high intensity on DWI and low signal intensity on ADC due to diffusion restriction
- #### T1WI C+
- Degree of enhancement variable depending on severity of ischemia and infarction
- Best for twisted pedicle and evaluating for underlying mass
- ### Imaging Recommendations
- #### Best imaging tool
- Endovaginal US with both grayscale and color Doppler is best initial imaging examination when torsion is suspected, particularly in premenopausal women
- Overall diagnostic accuracy of US is 79%, compared with 42% for CT
- CT/MR more likely to show twisted pedicle
## DIFFERENTIAL DIAGNOSIS
- ### Corpus Luteum With Ovarian Stromal Edema
- Presence of corpus luteum may cause ovarian stromal edema and results in pelvic pain and ovarian enlargement, mimicking ovarian torsion on US
- Increased blood flow in periphery of corpus luteum on color Doppler US or CECT is more common with corpus luteum and stromal edema but may occasionally persist in acute adnexal torsion
- ### Torsed Pedunculated Leiomyoma
- Both conditions manifest as large pelvic masses adjacent to but separate from uterus
- Identification of ovaries separate from mass enables exclusion of ovarian torsion
- ### Ectopic Pregnancy
- Positive β-hCG
- Extraovarian echogenic mass (clot)
- Adnexal ring separate from ovary with increased flow ("ring of fire")
- Visualization of embryo or yolk sac within tubal gestational sac
- Free fluid in pelvis and Morrison pouch from hemoperitoneum
- ### Pelvic Inflammatory Disease
- Uniformly thickened and dilated fallopian tubes
- Pyosalpinx
- Contains low-level echoes or fluid-fluid level
- ± enlarged ovaries secondary to oophoritis
- Normal or increased flow pattern on color Doppler
- ± tuboovarian abscess
- Complex cystic/solid masses
- Indefinite uterus sign
- Obscuration of posterior margin of myometrium by inflammation
## PATHOLOGY
- ### General Features
- #### Etiology
- Ovary rotates on its axis to cause twist in suspensory ligament that contains vascular pedicle
- This leads initially to venous and lymphatic congestion and subsequent compromise to arterial flow
- Severity of vascular impairment depends on degree of rotation (180-720°) and whether there is some preservation of arterial flow to ovary from its dual supply
- In adults, 50-90% have associated ovarian mass, usually benign
- Large, physiologic follicular cyst or corpus luteum cyst is most common
- Masses > 5 cm in diameter are at increased risk for adnexal torsion
- Dermoid, paraovarian cyst, and epithelial and stromal tumors can also serve as lead points for torsion
- Infants and children rarely have associated mass
- Hypermobility due to long mesosalpinx
- Isolated tubal torsion may occur due to hydrosalpinx, hematosalpinx, tubal neoplasms, tubal ligation, tubal hypermotility, and hydatids of Morgagni
- ### Gross Pathologic & Surgical Features
- Earliest pathologic changes include edema and microscopic hemorrhage within ovary
- Begins centrally
- Prominent, fluid-filled follicles displaced peripherally by central edema
- Late findings include hemorrhagic infarction
- Cystic spaces filled with blood and associated hemoperitoneum
- Calcified mass in chronic cases
## CLINICAL ISSUES
- ### Presentation
- #### Most common signs/symptoms
- Severe, unremitting, acute pelvic pain is most common symptom
- Pain may be intermittent torsion/detorsion
- Adnexal mass may or may not be palpable
- Nausea and vomiting occur in 70% of patients with adnexal torsion
- When present, torsion should always be considered as likely diagnosis
- Fever if ovary is infarcted
- ### Demographics
- #### Epidemiology
- Affects ~ 2-3% of female patients who present with acute pelvic pain
- Most common in first 3 decades
- More common during pregnancy
- Usually before 20 weeks
- As uterus enlarges, ovaries are pushed out of pelvis, increasing risk of torsion
- Increased risk in women undergoing ovarian stimulation
- Increased risk in women with prior pelvic or abdominal surgery
- ### Natural History & Prognosis
- Spontaneous detorsion can recur
- Massive ovarian edema felt to result from episodes of intermittent torsion with detorsion
- Usually long history of intermittent pain
- Presence of venous flow indicates viable ovary
- If no flow seen, ovary is infarcted
- ### Treatment
- Surgical untwisting in noninfarcted adnexa either with laparoscopy or open surgery
- Preservation of ovary is possible if normal blood flow is restored after detorsing ovary
- Careful examination and removal of any mass serving as lead point
- Salpingo-oophorectomy in infarcted ovary
## DIAGNOSTIC CHECKLIST
- ### Consider
- Ectopic in pregnant patient
- ### Image Interpretation Pearls
- Absent venous flow in enlarged, echogenic ovary with prominent peripheral follicles is earliest reliable sign
- Presence of normal blood flow does **not** exclude torsion
- Always look for underlying mass
95906236-ab1d-4131-a8ad-c2a217ea1042
## References
## Selected References
1. [Akçay A et al: Magnetic resonance imaging characteristics of ovarian torsion: insights into diagnostic features. Abdom Radiol (NY). 50(6):2694-702, 2025](http://www.ncbi.nlm.nih.gov/pubmed/?term=39592478%5Bpmid%5D)
1. [Dick EA et al: ESR essentials: gynaecological causes of acute pelvic pain in women: a primer for emergent evaluation-practice recommendations by the European Society of Emergency Radiology. Eur Radiol. ePub, 2025](http://www.ncbi.nlm.nih.gov/pubmed/?term=40397032%5Bpmid%5D)
1. [Dawood MT et al: Adnexal torsion: review of radiologic appearances. Radiographics. 41(2):609-24, 2021](http://www.ncbi.nlm.nih.gov/pubmed/?term=33577417%5Bpmid%5D)
1. [Moro F et al: Imaging in gynecological disease (20): clinical and ultrasound characteristics of adnexal torsion. Ultrasound Obstet Gynecol. 56(6):934-43, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31975482%5Bpmid%5D)
1. [Rogers D et al: Corpus luteum with ovarian stromal edema is associated with pelvic pain and confusion for ovarian torsion. Abdom Radiol (NY). 44(2):697-704, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=30244282%5Bpmid%5D)
1. [Rogers D et al: Peripheral hypervascularity of the corpus luteum with ovarian edema (CLOE) may decrease false positive diagnoses of ovarian torsion. Abdom Radiol (NY). 44(9):3158-65, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=31172211%5Bpmid%5D)
1. [Canning DA: Re: ovarian torsion: diagnosis of inclusion mandates earlier intervention. J Urol. 191(1):212-3, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24331506%5Bpmid%5D)
1. [Erikci VS et al: Isolated salpingeal torsion in children: a case series and review of the literature. Ulus Travma Acil Cerrahi Derg. 20(1):75-8, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24639322%5Bpmid%5D)
1. [Lourenco AP et al: Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol. 21(2):179-87, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24078282%5Bpmid%5D)
1. [Munshi S et al: Laparoscopic detorsion for bilateral ovarian torsion in a singleton pregnancy with spontaneous ovarian hyperstimulation syndrome. J Hum Reprod Sci. 7(1):66-8, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24829535%5Bpmid%5D)
1. [Sasaki KJ et al: Adnexal torsion: review of the literature. J Minim Invasive Gynecol. 21(2):196-202, 2014](http://www.ncbi.nlm.nih.gov/pubmed/?term=24126258%5Bpmid%5D)
1. [Geimanaite L et al: Ovarian torsion in children: management and outcomes. J Pediatr Surg. 48(9):1946-53, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=24074673%5Bpmid%5D)
1. [Morton MJ et al: Case report: ovarian torsion in pregnancy - diagnosis and management. J Emerg Med. 45(3):348-51, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=23810116%5Bpmid%5D)
1. [Duigenan S et al: Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. AJR Am J Roentgenol. 198(2):W122-31, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=22268201%5Bpmid%5D)
1. [Sibal M: Follicular ring sign: a simple sonographic sign for early diagnosis of ovarian torsion. J Ultrasound Med. 31(11):1803-9, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=23091252%5Bpmid%5D)
1. [Wilkinson C et al: Adnexal torsion -- a multimodality imaging review. Clin Radiol. 67(5):476-83, 2012](http://www.ncbi.nlm.nih.gov/pubmed/?term=22137723%5Bpmid%5D)
1. [Cicchiello LA et al: Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am. 38(1):85-114, viii, 2011](http://www.ncbi.nlm.nih.gov/pubmed/?term=21419329%5Bpmid%5D)
1. [Mashiach R et al: Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 30(9):1205-10, 2011](http://www.ncbi.nlm.nih.gov/pubmed/?term=21876091%5Bpmid%5D)
1. [Hiei K et al: Ovarian torsion; early diagnosis by MRI to prevent irreversible damage. Clin Exp Obstet Gynecol. 37(3):233-4, 2010](http://www.ncbi.nlm.nih.gov/pubmed/?term=21077534%5Bpmid%5D)
1. [Breech LL et al: Adnexal torsion in pediatric and adolescent girls. Curr Opin Obstet Gynecol. 17(5):483-9, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=16141762%5Bpmid%5D)
1. [Cass DL: Ovarian torsion. Semin Pediatr Surg. 14(2):86-92, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15846564%5Bpmid%5D)
1. [Ogburn T et al: Adnexal torsion: experience at a single university center. J Reprod Med. 50(8):591-4, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=16220764%5Bpmid%5D)
1. [White M et al: Ovarian torsion: 10-year perspective. Emerg Med Australas. 17(3):231-7, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15953224%5Bpmid%5D)
1. [Gittleman AM et al: Ovarian torsion: CT findings in a child. J Pediatr Surg. 39(8):1270-2, 2004](http://www.ncbi.nlm.nih.gov/pubmed/?term=15300544%5Bpmid%5D)
1. [Lambert MJ et al: Gynecologic ultrasound in emergency medicine. Emerg Med Clin North Am. 22(3):683-96, 2004](http://www.ncbi.nlm.nih.gov/pubmed/?term=15301846%5Bpmid%5D)
1. [Ratani RS et al: Pediatric gynecologic ultrasound. Ultrasound Q. 20(3):127-39, 2004](http://www.ncbi.nlm.nih.gov/pubmed/?term=15322390%5Bpmid%5D)
1. [Webb EM et al: Adnexal mass with pelvic pain. Radiol Clin North Am. 42(2):329-48, 2004](http://www.ncbi.nlm.nih.gov/pubmed/?term=15136020%5Bpmid%5D)
1. [Crouch NS et al: Ovarian torsion: to pex or not to pex? Case report and review of the literature. J Pediatr Adolesc Gynecol. 16(6):381-4, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=14642961%5Bpmid%5D)
1. [Ignacio EA et al: Ultrasound of the acute female pelvis. Ultrasound Q. 19(2):86-98; quiz 108-10, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12973093%5Bpmid%5D)
1. [Nishino M et al: Magnetic resonance imaging findings in gynecologic emergencies. J Comput Assist Tomogr. 27(4):564-70, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12886145%5Bpmid%5D)
1. [Ozcan C et al: Adnexal torsion in children may have a catastrophic sequel: asynchronous bilateral torsion. J Pediatr Surg. 37(11):1617-20, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=12407550%5Bpmid%5D)
1. [Promecene PA: Laparoscopy in gynecologic emergencies. Semin Laparosc Surg. 9(1):64-75, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=11979412%5Bpmid%5D)
1. [Rha SE et al: CT and MR imaging features of adnexal torsion. Radiographics. 22(2):283-94, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=11896219%5Bpmid%5D)
## Differential diagnosis
### Solid Adnexal Mass
DDX:1fc7c531-ac70-43f7-91a7-a6e01b8e616b
### Acute Left Abdominal Pain
DDX:65c32297-ce9e-41dd-80b5-60fd7160f2a6
### Acute Right Lower Quadrant Pain
DDX:0cf67a29-c8c8-4ffc-83d6-99f0ee0b8dd8
### Ovarian Mass
DDX:3f581609-2dac-4456-ac58-01b68c7535aa
### Pelvis Mass
DDX:a912daa3-bd98-43dd-8310-290393f4def9
### Cystic Adnexal Mass
DDX:88a31011-4bc5-45b0-8aea-e7872b12257c
### Enlarged Ovary
DDX:373571ed-1233-42d9-a38f-5158d7a41ab9
### Extraovarian Adnexal Mass
DDX:6848b567-4e17-4acd-8afc-7341d24ae30b
## Anatomy
### Anatomy of the Adnexa
Gynecology/ANATOMY:768ca129-7f1f-436c-97a5-ecd0f63f6441
### Ovaries
Gynecology/ANATOMY:19736b1f-b15c-4275-8f1d-52fab6873235
### Ovaries
Ultrasound/ANATOMY:2d5c024d-0613-45e5-a741-6bb222aa26eb
## Cases
- {'cases': [{'authors': [{'key': 'da7b7f87-c980-4378-9f2c-8b4499c8a7e9', 'value': 'Maryam Rezvani, MD'}], 'caseVersionId': 'b08cddd1-2ff1-4092-bad6-2166e4d87a06', 'description': 'Axial CECT (#1) shows a large, simple-appearing cystic mass (arrows) in the left hemiabdomen. Coronal CECT (#2) shows the large cystic mass (arrow) with an associated pedicle (open arrow) extending out of the left hemipelvis. The pedicle has a twisted configuration.', 'history': 'Sudden onset of severe left lower quadrant pain.', 'imagePoolId': '549b8444-c639-4ef7-8866-eef19bed877d', 'name': 'Ovarian torsion on CT', 'teachingPoint': None, 'demographics': '37 Years old female'}, {'authors': [{'key': 'b4e1fa52-80a4-4e86-9e6f-beb2fe21629b', 'value': 'Aya Kamaya, MD, FSRU, FSAR'}], 'caseVersionId': 'dc88dd6d-8863-4ab8-9208-63c201ff8389', 'description': 'Transverse grayscale view of the left adnexa (Vid. 1) shows a swirl of tissue leading to an enlarged ovary (measuring &gt; 5 cm) with numerous hemorrhagic peripheral follicles. The patient was confirmed to have a torsed left ovary with twist upon the pedicle of 360&deg;.', 'history': 'Patient presents with severe left pelvic pain.', 'imagePoolId': '548443c4-c87b-42d8-a5a8-d5eb8c1c819b', 'name': 'Ovarian Torsion With Twisted Pedicle', 'teachingPoint': '{b| }{b|} The best diagnostic clue for the presence of torsed ovary/adnexa is an enlarged ovary greater than 5 cm in dimension in combination with a compatible clinical presentation. In this patient, detectable venous and arterial waveforms (not shown) were likely present because the ovary was only twisted 360°. Indeed, the presence of detectable vascularity on color Doppler of an ovary does not exclude the diagnosis of torsion.', 'demographics': '45 Years old female'}, {'authors': [{'key': '0862cce4-8709-43f7-8c54-09d750de22fb', 'value': 'Deborah Levine, MD'}], 'caseVersionId': 'e1d7e339-7580-4fd0-bbc9-e72bae0f5afd', 'description': 'Transverse (#1) and coronal (#2) CT show a large right adnexal mass (arrows). Transabdominal US (#3,4) show the adnexal mass (calipers, #3,4) as an edematous ovary that measured 10 x 6 cm x 6 cm. Color Doppler (#5,6) show flow within the ovary. Pulsed Doppler sonogram (#7) shows a whorled appearance of the adnexal vessels (curved arrow) and abnormal Doppler flow with pulsatile venous flow (open arrow) and absent diastolic flow (arrow).', 'history': 'Mid-abdominal pain becoming right lower quadrant pain. CT performed to rule out appendicitis. Ultrasound performed due to CT findings.', 'imagePoolId': '025737ce-6fde-4bf4-88e3-91ec923703eb', 'name': 'Mass', 'teachingPoint': None, 'demographics': '21 Years old female'}, {'authors': [{'key': 'da7b7f87-c980-4378-9f2c-8b4499c8a7e9', 'value': 'Maryam Rezvani, MD'}], 'caseVersionId': '4432e000-b617-4391-9aae-900ce96b0908', 'description': 'Coronal CECT (#1) shows a cystic mass (arrow) arising out of the left hemipelvis with a twisted pedicle (open arrow). At surgery, the cystic mass was found to be simple physiologic cyst of the ovary acting as a lead point for torsion.', 'history': 'Abrupt onset of left lower quadrant and left flank pain.', 'imagePoolId': '3899511b-6aa5-4ee1-b5c4-445f31106339', 'name': 'Ovarian torsion with physiologic cyst, CT', 'teachingPoint': None, 'demographics': '41 Years old female'}, {'authors': [{'key': '8e8c445a-2b2f-435d-b348-855b7921ad53', 'value': 'Christopher G. Anton, MD'}], 'caseVersionId': '5059cabb-3d0a-4b49-9117-1ac2800fe7ac', 'description': 'Typical case of ovarian torsion on transabdominal ultrasound.\n\nUltrasound (#1-3) show a heterogeneous (12 cm) enlarged right ovary with small predominantly periphery located cysts (arrows). Ultrasound (#3) shows absent color flow within the right ovary. Pulsed Doppler imaging also did not detect any arterial or venous flow. The ovary was massively enlarged with a volume calculated to be 688 mL.', 'history': 'Patient with lower abdominal pain was admitted for observation for possible appendicitis. Upon surgeons physical examination there was lower abdominal tenderness and fullness within the right side of the pelvis found.', 'imagePoolId': '89bb16bf-5803-4da1-9c6f-b763162aa7a6', 'name': 'Peripheral cysts', 'teachingPoint': None, 'demographics': '12 Years old female'}], 'caseType': 'typical', 'name': 'TYPICAL'}
- {'cases': [{'authors': [{'key': '8e8c445a-2b2f-435d-b348-855b7921ad53', 'value': 'Christopher G. Anton, MD'}], 'caseVersionId': 'f283eafe-5f26-4004-a004-0b87d547d4a3', 'description': 'Variant case of ovarian torsion on CECT and ultrasound.\n\nCECT (#1-3) shows an enlarged heterogeneous mass (black arrows) located immediately cephalad and anterior to the cystic mass (white arrows, #2-4). The left ovary is identified (curved arrow, #3). Notice the septate uterus (open arrow, #4). Ultrasound (#5, 6) show the cystic mass (white arrows) posterior to the uterus (curved arrows, #5, 6). Right ovarian tissue is identified (black arrows, #6). Ultrasound (#7) demonstrates the absence of color flow within the right ovary. A claw of right ovarian tissue (black arrows, #6, 7) is noted along the anterior superior aspect of the cystic mass (whit arrow, #7). At surgery a torsed right ovary and fallopian tube with a broad ligament cyst was found.', 'history': 'Patient presents with right lower quadrant pain.', 'imagePoolId': 'c025a17f-8072-4c01-a507-147c7dc6ef7e', 'name': 'Cystic ovarian mass', 'teachingPoint': None, 'demographics': '13 Years old female'}, {'authors': [{'key': '8e8c445a-2b2f-435d-b348-855b7921ad53', 'value': 'Christopher G. Anton, MD'}], 'caseVersionId': '9c751e0f-b181-4f46-919a-c4dc6777973c', 'description': 'Variant case of ovarian torsion on ultrasound.\n\nUltrasound (#1, 2) shows a heterogeneous enlarged right ovary with no detectable color flow (#2). Pulse Doppler imaging also could not detect significant arterial or venous flow within the right ovary. The right ureter drapes along the posterior margin of the right ovary (arrows, #1). The volume of the right ovary was calculated to be 94 mL compared to 7 mL of the left ovary. Torsed right ovary was found at surgery.', 'history': 'Patient presents for an ultrasound of the kidney in follow-up of hydronephrosis and chronic renal insufficiency. Incidental ovarian mass was found when imaging the urinary bladder.', 'imagePoolId': 'b7f705c6-fcd3-41f8-9fed-c8e32cb2dabe', 'name': 'Large adnexal mass', 'teachingPoint': None, 'demographics': '14 Years old female'}, {'authors': [{'key': 'b4878f39-1986-46a3-9bc4-67d90a7aed9c', 'value': 'Sean Curran, MD'}, {'key': '7667fad7-f34b-43bc-8704-408f290e7516', 'value': 'Hedvig Hricak, MD, PhD, Dr hc'}], 'caseVersionId': 'a1541b32-9d28-4a4f-b97f-73803c0c4ce2', 'description': 'Variant case of chronic ovarian torsion. \n\nMR shows a heterogeneous high signal intensity mass on both T1 and T2 in the cul de sac. Note the low signal rim peripherally on both T1 and T2 (arrows, #1-3) which represents hemosiderin (repeated hemorrhage over time). The plain film (not shown) did not demonstrate calcification. \n\nComment: The differential would include an exophytic degenerated leiomyoma with peripheral calcification.', 'history': 'Pelvic mass.', 'imagePoolId': '7695905f-9176-42c2-8110-20134b57e4b7', 'name': 'Chronic', 'teachingPoint': None, 'demographics': '71 Years old female'}, {'authors': [{'key': '0862cce4-8709-43f7-8c54-09d750de22fb', 'value': 'Deborah Levine, MD'}], 'caseVersionId': 'a4149ce4-24c2-42a1-be70-97e74d4eb833', 'description': "The right ovary (#1) is enlarged measuring 6 cm in diameter (open arrows). The ovary has a round appearance and the follicles are located in the periphery of the ovary. Blood flow is seen within the ovary (arrow, #2) with normal arterial and venous waveforms (#3). \n\nComment: Because of the severe nature of the patient's pain, torsion was suspected, despite normal vascular waveforms. Torsion was found at surgery.", 'history': '15 weeks pregnant with severe right lower quadrant pain.', 'imagePoolId': 'ec0ae1df-0590-4d19-a1da-698e734745ca', 'name': 'Pregnant', 'teachingPoint': None, 'demographics': '35 Years old female'}], 'caseType': 'variant', 'name': 'VARIANT'}
results.json
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// @version 1.2
// @description Captures STATdx content (JSON/HTML/images) passively and sends it to the central cache server.
// @author Antigravity
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