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Urogenital Imaging

Uterus, retroverted

The uterus is usually angled anteriorly, from external os to fundus. Up to 20% of women demonstrate a posterior angulation with the fundus lying behind the external os. This is known as uterine retroversion, and the angle refers to the relationship between the long axis of the uterus and the vagina. The variance in position may be intermittent, and can sometimes by reversed by bimanual palpation. In most cases, this represents a normal variant. Occasionally, a retroverted uterus may cause chronic pelvic pain, but this association is probably more often coincidental than causal. At hysterosalpingography HSG , uterine retroversion is recognized by an inverted appearance of the endometrial cavity. The posterior angulation of the uterus is also readily appreciated at ultrasound, CT and MRI. Perhaps the most important feature of uterine retroversion, from the viewpoint of imaging, is that it limits sonographic evaluation of the uterus, by both transabdominal and transvaginal approaches.

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