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Background
To discuss the normal physiologic processes that may lead to the development of acutely painful pelvic lesions in women. To elaborate on the most common causes of acute pelvic pain in premenopausal women. To describe the US appearances of acutely painful pathologic conditions in the female pelvis.

Educational Goals / Teaching Points
Classification of lesions causing acute pelvic pain in premenopausal women according to their origin (gynecological and non-gynecological). Case-based examples understanding of ultrasound's role in the evaluation of different pathologies causing acute pelvic pain in non-pregnant pre-menopausal patients. Approach to acute pelvic pain in pregnant and postpartum patients. Evaluation of acute pelvic pain in the adolescent female. Demonstration of the characteristic appearance of different pathologies causing acute pelvic pain on ultrasound with case-based examples: follicular ring sign & whirlpool sign in ovarian torsion, network appearance in ovarian hemorrhagic cyst, etc.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The exhibit provides a comprehensive overview of the differential diagnosis of acute pelvic pain in women within the reproductive period. The exhibit discusses the ultrasound findings in premenopausal patients with acute pelvic pain through case-based examples. The exhibit demonstrates the role of ultrasound in discrimination between lesions causing acute pelvic pain that can be managed conservatively, and those requiring emergency/urgent surgical intervention. The exhibit highlights the value of adding color Doppler examination in providing a more accurate diagnosis of different pathologies causing acute pelvic pain.

Conclusion
Ultrasonography is an ideal imaging modality that plays a major role in the prompt and accurate diagnosis and expeditious management of adnexal causes of acute pelvic pain in women of reproductive age and the accuracy of examination is increased through adding color Doppler.