CT scans (computerized tomography) and ordinary X-rays are of no value in the diagnosis and monitoring of endometriosis. Ultrasound can have a role in some situations.

Ultrasound involves the use of high frequency sound waves to create an image or picture of the body on a screen or film. Over the last decade it has been used increasingly in the diagnosis and management of a number of gynecological and obstetrical conditions, including the detection of ovarian cysts and determining the age and size of a foetus in early pregnancy.

Ultrasound has a limited role in the diagnosis and monitoring of endometriosis. At present, the machines used are not sensitive enough to detect small implants and adhesions. They can only detect cysts greater than two centimeters in diameter and determine their size and location. Ultrasound cannot determine the nature of a cyst nor can it distinguish it from other types of cysts or conditions.

Ultrasound should not be used as a substitute for laparoscopy to diagnose endometriosis. Its use is limited to confirming the existence of a cyst felt during a pelvic examination and determining its size and location prior to surgery. In some circumstances ultrasound may be used to help monitor the change in the size of a cyst after a laparoscopic diagnosis has been made.

Use of hysteroscopy or D&C in diagnosis

A hysteroscopy is a procedure where a telescope-like instrument is inserted into the uterus through the vagina and the cervix. It enables the gynecologist to examine the inside of the uterus.

A D&C (dilation and curettage) involves dilating or opening the cervix with a series of rods of increasing thickness until the opening of the cervix is dilated to about one centimeter in diameter. A thin spoon-shaped instrument, known as a curette, is inserted into the uterus and some of the lining is gently scraped off” and later examined.

Hysteroscopy and a D&C have no role in the diagnosis of endometriosis as they do not allow the gynecologist to examine the pelvic cavity.

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