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In the midst of COVID-19, @GeorgeCondous and I entirely missed the release of our article in @ContempOBGYN last week!

NON-INVASIVE #ULTRASOUND DIAGNOSIS OF #ENDOMETRIOSIS

contemporaryobgyn.net/endometriosis-…

This is a comprehensive review article accompanied by 17 videos!
This article should be read by anyone interested in endometriosis: sonographers, radiologists, gynecologists who want to learn how to perform ultrasound, gynecologists who want their sonogs/rads to start perform/interpreting ultrasound for endometriosis, patients, advocates, etc
I will share each video in its own tweet.

The videos depict normal and abnormal anatomy, including superficial, ovarian, deep endometriosis, rectouterune pouch obliteration, ovarian fixation.

They are accompanied by captions.
Normal ovary with circumferential mobility.

contemporaryobgyn.net/endometriosis-…
Ovarian endometrioma within laterally mobile ovary

contemporaryobgyn.net/endometriosis-…
Ovarian endometrioma within inferomedially immobile ovary densely fixed to deep endometriosis of the left uterosacral ligament.

contemporaryobgyn.net/endometriosis-…
Bilateral ovarian endometriomas, “kissing ovaries.”

contemporaryobgyn.net/endometriosis-…
Normal vagina

contemporaryobgyn.net/endometriosis-…
Posterior vaginal fornix deep endometriosis with bowel tethering

contemporaryobgyn.net/endometriosis-…
Normal bowel wall

contemporaryobgyn.net/endometriosis-…
Bowel deep endometriosis with rectouterine pouch obliteration

contemporaryobgyn.net/endometriosis-…
Normal uterosacral ligament and rectouterine pouch peritoneum

contemporaryobgyn.net/endometriosis-…
Uterosacral ligament deep endometriosis nodule

contemporaryobgyn.net/endometriosis-…
Uterosacral ligament deep endometriosis nodule causing hydroureter

contemporaryobgyn.net/endometriosis-…
Anteverted uterus, positive sliding sign (normal, non-obliterated rectouterine pouch)

contemporaryobgyn.net/endometriosis-…
Anteverted uterus, negative sliding sign (abnormal, obliterated rectouterine pouch)

contemporaryobgyn.net/endometriosis-…

(Link may not be working when you try to click, but it is being fixed and you can come back to it later).
Retroverted uterus, positive sliding sign (normal, non-obliterated rectouterine pouch)

contemporaryobgyn.net/endometriosis-…
Retroverted uterus, negative sliding sign (abnormal, obliterated rectouterine pouch)

contemporaryobgyn.net/endometriosis-…
Superficial endometriosis

contemporaryobgyn.net/endometriosis-…

Yes, it is possible to see superficial endometriosis on ultrasound and we are actively working to refine this so we can move to an era where people with possible endo can be be diagnosed non-invasively.
For transparency, we have acknowledged the limitations of ultrasound on page 5 of the article.

And even though I believe this should go without saying, we are not advocating against laparoscopy when ultrasound is normal, even in the hands of an endometriosis ultrasound expert.
Every day in our clinical practice, we talk to people who have had previous normal imaging tests. We either hear their story about their subsequent lap where endo was found or we scan them and diagnose endo (non-invasively).
We are incredibly aware of how poor gyne u/s is for endometriosis worldwide. We have recently published an article on the awareness of gynecologists for endometriosis ultrasound.

If you want a copy of this article, you can request it from me here:
researchgate.net/publication/33…
We are also working on the manuscript for a study on the international awareness of people for endometriosis ultrasound/other imaging modalities. Not surprisingly, it is overall very low.
We prepared the @ContempOBGYN article to continue to raise awareness and education. We hope those of you with large endometriosis patient populations or social media followings will make an effort to read this article and watch the videos and share widely. contemporaryobgyn.net/endometriosis-…
@GynaecologyUS @AliUltrasound @proftombourne @Mikhail_MIGS @LauriHochberg @DrSonySinghMD @DrAllaire @DrPaulYong @ISUOG @AAGL @CanSAGE @TheEndoNetwork @EndometriosisAu @WorldEndoSoc @endo_ireland @EndometriosisUK @NZEndo @nancynursez637 @CamranNezhatMD @NezhatMedical @citizen_endo
@JonIEinarsson @JovanaTavcar @WRossMD @Peter_Movilla @BortolettoMD @nisseclark @MigsRunner @cristobal_rdz @cacongupi @DrDanielGinn @DrMTruong @OlgaMuldoonMD @sadikah6 @DrSamarNahas1 @DrOshinowo @malstumd @WassonMegan @n_donovan14 @JamesMNDuffy @JamesCaseyMD @docfoleygyn @temkins
@drcaraking @abrao_mauricio @ProfNeilJ_Gynae @AGES_Society @FMIGS1 @ArtArellano @dmitry_fridman @TassieObGyn @DRouselle @OntarioObgyns @DrAng_OzGyn @LauraCedoMD @PossoverA @ChrisDeSteph @devoncevans @siddhi_mathur @rebchern @MichaelChaikof @anj_90 @laraeparker @horne_research
@l_farland @p_saunder @eeyanmiller @drmiguelluna @SezClom @DrJenGunter @BirthControlDoc @drlindayang @KimberlyKho1 @cclareMDMPH @MKvaskoff @NMoawad_MIGS @Dr_Tu_gynesurg @MoMIGSMD @DrBParlett @louise_p_king @martinhirsch100 @YeungJr @Jimi_Odejinmi
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Mathew Leonardi MD
@mathewleonardi
I used to be a gynaecologist.
Now I am a gynaecologist and sonologist (def: lexico.com/en/definition/…).
My perspective on many aspects of gynaecology has changed.

This is a tweetorial on OVARIAN CYSTS.

Inspired by the @iotacongress group and @isuog
doi.org/10.1046/j.1469…

1/
The term cyst has come to mean abnormality for patients and clinicians alike. This causes anxiety. In most cases, it shouldn’t. @proftombourne @GeorgeCondous

Most cysts found within/next to an ovary are normal.
Two examples: 1- follicular cysts and 2- corpus luteum cysts.

2/
Follicular cysts, or simply follicles, as I like to call them, develop every natural menstrual cycle. Anything that is unilocular with clear contents and <3cm should be described as a follicle. Removal of the term “cyst” diminishes unnecessary anxiety.

@GynaecologyUS

3/
Read 11 tweets

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