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Endometriosis with normal ultrasound — DRCOG MCQ

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HardGynaecologyEndometriosis with normal ultrasoundDRCOG

A 31-year-old has chronic pelvic pain and deep dyspareunia, but pelvic examination and transvaginal ultrasound are normal. What should she be told?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Normal examination and ultrasound do not exclude endometriosis

The best answer is “Normal examination and ultrasound do not exclude endometriosis”. NICE explicitly states that normal examination and ultrasound do not exclude endometriosis. Initial analgesic and hormonal treatment can be considered, and persistent, recurrent or function-limiting symptoms warrant gynaecology referral; laparoscopy may still be considered after normal imaging.

Reference: NICE NG73: Endometriosis diagnosis and management: https://www.nice.org.uk/guidance/ng73/chapter/recommendations