Chapter 6: Pelvis

Introduction

As a module, the pelvis has very little surface area covered by skin and diagnosis relies heavily on imaging. The perineum is superficial and clinical diagnosis is easier. However, this superficiality also makes investigations, such as ultrasound, simple and easy for diagnosis confirmation.

• Posterior and lateral pelvic walls

• Pelvic cavity (with viscera)

• Anal triangle (perineum)

• Urogenital triangle (perineum)

The pelvis consists of four regions:

Normal Images

Prostate

Notes

Nocturia, frequency, dribbling.

Report

Diffuse prostatic enlargement (benign prostatic hypertrophy).

Treatment

Transurethral resection if significant symptoms.

Notes

History of prostatic symptoms, cachexia, bone pain, pathological fractures.

Report

Widespread sclerotic foci involving the pelvic bones (disseminated prostatic carcinoma).

Treatment

Treat symptoms. Palliative care. Surgery for fractures. Medical treatment.

Notes

Prostatic symptoms, bone pain.

Report

Mixed hyper and hypoechoic nodule at posterolateral periphery of prostate gland (prostatic carcinoma).

Treatment

Resection if possible.

Female Genital

Notes

Chronic pain and swelling suprapubically.

Report

Large benign ovarian cyst on left ovary.

Treatment

May require removal.

Notes

Cachexia, signs of bowel obstruction, abdominal swelling, possible other metastatic sites and symptoms.

Report

Numerous areas of intraperitoneal 'seeding' from ovarian carcinoma with secondary peritoneal edema and ascites.

Treatment

Palliative care at this stage.

Notes

Pain, discomfort, dysmenorrhea, infertility.

Report

Large benign fibroid seen in wall of uterus.

Treatment