Purpose or Case Report: Adnexal torsion is one of the most common gynecologic surgical emergencies. Delayed diagnosis could result in tissue necrosis, leading to loss of ovarian function and impaired fertility.

The goals of this exhibit are:
1. Review the anatomy of the female pelvis.
2. Discuss the incidence, risk factors, and clinical characteristics of adnexal torsion.
3. Describe the technical approach of performing pelvic ultrasound.
4. Illustrate the sonographic imaging spectrum of adnexal torsion.
5. Discuss diagnostic criteria of adnexal torsion.
Methods & Materials: Ultrasound exams at our institutions were reviewed retrospectively with selected cases chosen to illustrate technical aspects and to demonstrate imaging features of surgically confirmed adnexal torsion in females. Correlation was made in conjunction with diagnostic laparoscopy, follow up imaging studies and clinical/surgical outcomes.
Results: Imaging findings of surgically confirmed adnexal torsion will be illustrated.
Conclusions: Adnexal torsion often presents with non-specific symptoms that may be attributed to other causes. Sonography is frequently utilized as the first line of imaging to investigate acute lower abdominal and pelvic pain. Recognition of sonographic imaging features of adnexal torsion improves diagnostic accuracy, resulting in prompt restoration of blood flow and improved fertility outcomes.