USG AND PEDIATRIC SPINAL CANAL :

• To determine the level of conus medullaris - look for tethered cord


• Myelomeningocele, meningocele, lipomyelomeningocele, hydromyelia, syringomyelia, syringohydromyelia, diastematomyelia


• Lipoma

• Bicornuate, unicornuate and T shaped uterus
• Obstruction of the vagina resulting in hydrocolpos or hydrometrocolpos (vaginal atresia, imperforated hymen, vaginal septum)
• Uterine hypoplasia
• Streak ovaries - Turner's syndrome

• Rhabdomyosarcoma
• Endodermal sinus tumour
• Adenocarcinoma of cervix
• Carcinoma of vagina (h/o in utero exposure to diethylstilbestrol)
• Gartner's duct cyst
• Paramesonephric (Mullerian) duct cyst

• Ovarian cysts
• Primary ovarian tumours: -
  
          Germ cell tumours - Benign teratoma, dysgerminoma (common),         embryonal cell carcinoma (rare), endodermal sinus tumour (rare)
          Epithelial tumours - Serous & mucinous adenocarcinoma are rare         before puberty
          Stromal tumour - Granulosa theca cell tumour
          Acute leukaemia

• New born infant with ambiguous genitalia to look for presence / absence of uterus and vagina.
• Investigation for primary amenorrhoea - to assess uterine - size, shape & maturity, ovarian development


Gonadal dysgenesis


• Turner's syndrome (ovarian absent or streak)
• Swyer's syndrome (pure gonadal dysgenesis)
• Noonan's syndrome (pseudo-Turner's syndrome)(normal ovarian function & normal ovaries on ultrasound)
• Testicular feminization: Absent uterus & ovaries, blind ending vagina. Testis are ectopic (pelvic).


Precocious puberty - Uterus enlarged and ovarian volume > 1cc before the age of 8 yrs.


• Pseudoprecocious puberty - Usually secondary to ovarian tumours -> granulosa theca cell tumour, dysgerminoma,functional ovarian cyst, teratoma, choriocarcinoma, feminizing adrenal tumours.