In evaluating an adolescent with gynecologic complaints, which finding would indicate ordering a pelvic ultrasound?

In evaluating an adolescent with gynecologic complaints, which finding would indicate ordering a pelvic ultrasound?

• A. Amenorrhea with normal exam.
• B. Palpable pelvic mass.
• C. Regular menses with no symptoms.
• D. Normal ultrasound finding.

Answer: (B)

A palpable pelvic mass in an adolescent with gynecologic complaints signals imaging to figure out what the mass is and how to manage it. Pelvic ultrasound is the best first step because it can show where the mass comes from (ovary, uterus, or another structure), its size and exact location, and its characteristics—whether it’s simple or complex, solid or cystic, and whether there are features suggesting blood flow or torsion. This information helps distinguish benign functional cysts from more concerning masses and guides whether surgical evaluation or monitoring is needed. Ultrasound is preferred in teens because it’s noninvasive and avoids radiation. By contrast, amenorrhea with a normal exam, regular menses with no symptoms, or a normal ultrasound finding aren’t by themselves indications to image; imaging is driven by the presence of a mass or other clinical concern.

A palpable pelvic mass in an adolescent with gynecologic complaints signals imaging to figure out what the mass is and how to manage it. Pelvic ultrasound is the best first step because it can show where the mass comes from (ovary, uterus, or another structure), its size and exact location, and its characteristics—whether it’s simple or complex, solid or cystic, and whether there are features suggesting blood flow or torsion. This information helps distinguish benign functional cysts from more concerning masses and guides whether surgical evaluation or monitoring is needed. Ultrasound is preferred in teens because it’s noninvasive and avoids radiation. By contrast, amenorrhea with a normal exam, regular menses with no symptoms, or a normal ultrasound finding aren’t by themselves indications to image; imaging is driven by the presence of a mass or other clinical concern.