Gynaecological and Adnexal Imaging
Evaluate pelvic pain, bleeding, uterine and adnexal masses, infertility and gynaecological malignancy.
How to prepare for the current Final FRCR Part A
Build general-radiology breadth, then practise integrating clinical context, anatomy, multimodality findings, technique and management to select the single best answer.
Core concepts
Concept 1
Localise uterine, ovarian, tubal or extra-gynaecological origin and integrate cycle, age, morphology, vascularity, diffusion and spread.
Exam cue: Localise the abnormality and identify the organ, compartment, tissue or vessel before naming a diagnosis.
Concept 2
Use transabdominal and transvaginal ultrasound first where appropriate, with MRI for characterisation and CT for acute or wider oncological assessment.
Exam cue: Use age, clinical setting, tempo and the complete multimodality pattern to rank the most likely explanation.
Concept 3
Recognise torsion, ectopic pregnancy, haemorrhage, abscess and malignant features requiring urgent or specialist care.
Exam cue: Select the examination or intervention that changes management while accounting for contrast, radiation, access and urgency.
Concept 4
Apply normal and variant anatomy, modality technique, image quality and relevant imaging science to gynaecological and adnexal imaging.
Risk pitfalls and guardrails
Interpreting an adnexal lesion without menopausal status, pregnancy testing, prior imaging and the limitations of a single modality.
Guardrail: Do not anchor on one remembered sign; verify age, localisation, distribution, technique, alternatives and management consequence.
Do not choose a merely plausible SBA option before comparing every option with the full clinical and imaging context.
Guardrail: Re-read the command word and compare every option; the task is to select the best available answer, not the first plausible one.
Memory anchors
Adnexal mass first decisions
Confirm organ of origin, simple versus complex morphology, solid vascular components and acute complications.
Ovarian torsion
An enlarged oedematous ovary, peripheral follicles and twisted pedicle support diagnosis, but preserved flow does not exclude it.
Fibroid versus adenomyosis
Fibroids are usually discrete myometrial masses; adenomyosis more often causes junctional-zone and diffuse myometrial change.
Pelvic malignancy assessment
Report local compartment invasion, nodes, peritoneum, urinary obstruction and distant features that change treatment.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A woman has heavy menstrual bleeding. Ultrasound shows a well-defined hypoechoic whorled myometrial mass with edge shadowing. What is the diagnosis?
MRI shows diffuse thickening of the uterine junctional zone with punctate high T2 myometrial cysts. What is the diagnosis?
Answer all questions to submit.
Next step personalized recommendations
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Move forward only after this module is stable.
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