Purpose or Case Report: There is significant variation in the approach to diagnosing PCOS (polycystic ovarian syndrome), particularly in adolescents. PCOS, more recently referred to as hyperandrogenic anovulation, is a classic tried of oligomenorrhea and/or anovulation, hirsutism, and obesity. The Rotterdam criteria are widely used in the adult population, with diagnostic criteria including 2 of the following 3: ovulatory dysfunction, clinical and/or biochemical signs of hyperandrogenism, polycystic ovarian morphology on ultrasound. Although it is acknowledged that ultrasound is not necessary for diagnosing PCOS in adults if the first 2 criteria are met, there is sufficient controversy in adolescent literature that classic morphologic appearance in addition to one other criterion may not be diagnostic.
Polycystic ovarian morphology (PCOM), the imaging correlate typically associated with the clinical diagnosis of PCOS, can be a normal finding in adolescents. Given that the criteria for the polycystic ovarian morphology (PCOM) remains controversial, it is important for a pediatric radiologist to understand the significance of PCOM in adolescents, and how radiology can best and most significantly add to the clinical picture.
This presentation will provide a review of consensus guidelines for PCOS and PCOM, and best practices of describing findings of PCOM in adolescents. Novel approaches will also be discussed, including ongoing research in follicle counts and stromal volume with 3D ultrasound.
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