Abstract
Acute pelvic pain in pediatric female patients is a common cause of emergency room visits. Imaging plays a crucial role in the clinical evaluation of these patients. Pelvic pain in female children can result from various pathologies. Ultrasound is the preferred first line imaging study; however, magnetic resonance imaging (MRI) is a helpful adjunct after hours, as it is available 24/7 in many institutions. Advantages of MRI include superior delineation of anatomy and higher tissue contrast resolution, particularly of the small pelvic structures. Given the lack of ionizing radiation, there is increasing use of MRI in children and adolescents, specifically in an emergent setting. In this pictorial review, we discuss pelvic MRI techniques and illustrate imaging findings of common etiologies of pelvic pain, emphasizing the advantages of MRI as an adjunct imaging modality.
Similar content being viewed by others
References
Babcock DS (2002) Sonography of the acute abdomen in the pediatric patient. J Ultrasound Med 21(8):887–899 quiz 900-1
Strouse PJ (2003) Imaging and the child with abdominal pain. Singap Med J 44(6):312–322
Hryhorczuk AL, Lee EY (2012) Imaging evaluation of bowel obstruction in children: updates in imaging techniques and review of imaging findings. Semin Roentgenol 47(2):159–170
Jabra AA et al (2001) CT of small-bowel obstruction in children: sensitivity and specificity. AJR Am J Roentgenol 177(2):431–436
J, R. MRI Utilization Trends In a Large Tertiary Care Pediatric Emergency Department. in ACEP Research Forum 2010. 2010.
Scheinfeld MH et al (2017) MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years. Pediatr Radiol 47(3):327–332
Dillman JR et al (2016) Equivocal pediatric appendicitis: unenhanced MR imaging protocol for nonsedated children—a clinical effectiveness study. Radiology 279(1):216–225
Moore MM et al (2012) MRI for clinically suspected pediatric appendicitis: an implemented program. Pediatr Radiol 42(9):1056–1063
Paltiel HJ, Phelps A (2014) US of the pediatric female pelvis. Radiology 270(3):644–657
Epelman M et al (2013) Mullerian duct and related anomalies in children and adolescents. Magn Reson Imaging Clin N Am 21(4):773–789
Li Y et al (2016) Magnetic resonance imaging of Mullerian duct anomalies in children. Pediatr Radiol 46(6):796–805
Ngo AV et al (2015) Pediatric ovarian torsion: a pictorial review. Pediatr Radiol 45(12):1845–1855 quiz 1842-4
Cox M et al (2016) Magnetic resonance imaging of acquired disorders of the pediatric female pelvis other than neoplasm. Pediatr Radiol 46(6):806–817
Lourenco AP et al (2014) Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol 21(2):179–187
Orazi C et al (2006) Isolated tubal torsion: a rare cause of pelvic pain at menarche. Sonographic and MR findings Pediatr Radiol 36(12):1316–1318
Rezvani M, Shaaban AM (2011) Fallopian tube disease in the nonpregnant patient. Radiographics 31(2):527–548
Anthony EY et al (2012) Adnexal masses in female pediatric patients. AJR Am J Roentgenol 198(5):W426–W431
Chang PT, Schooler GR, Lee EY (2015) Diagnostic errors of right lower quadrant pain in children: beyond appendicitis. Abdom Imaging 40(7):2071–2090
Levy AD, Hobbs CM (2004) From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic correlation. Radiographics 24(2):565–587
Kotecha M et al (2012) Multimodality imaging manifestations of the Meckel diverticulum in children. Pediatr Radiol 42(1):95–103
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Ayyala, R.S., Khwaja, A. & Anupindi, S.A. Pelvic pain in the middle of the night: use of MRI for evaluation of pediatric female pathology in the emergent setting. Emerg Radiol 24, 681–688 (2017). https://doi.org/10.1007/s10140-017-1520-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-017-1520-8