Hysterosalpingography can diagnose all of the following except:
A. Endometrial polyp
B. Submucous fibroid
C. Subserous fibroid
D. Uterine septum
Correct Answer: C. Subserous fibroid
Explanation
Hysterosalpingography (HSG) can diagnose all of the following except:
👉 Endometriosis
Explanation
Hysterosalpingography is a radiographic procedure used mainly to assess the uterine cavity and fallopian tubes by injecting contrast dye.
Conditions HSG can diagnose:
- Tubal patency or tubal blockage
- Congenital uterine anomalies (septate, bicornuate uterus)
- Intrauterine adhesions (Asherman syndrome)
- Submucous fibroids and endometrial polyps
- Hydrosalpinx
Condition HSG cannot diagnose:
- Endometriosis ❌
- Endometriosis involves ectopic endometrial tissue outside the uterus
- It is best diagnosed by laparoscopy, not HSG
Key Point:
📌 HSG evaluates the uterine cavity and tubes, not ovarian or peritoneal pathology
Other Options Details
Here is a clear explanation of all the options:
A. Endometrial Polyp
- A localized overgrowth of endometrial tissue projecting into the uterine cavity.
- Can be sessile or pedunculated.
- Common symptoms:
- Abnormal uterine bleeding (menorrhagia, intermenstrual bleeding)
- Infertility or recurrent pregnancy loss
- Best diagnosed by ultrasound, hysteroscopy, or sonohysterography.
B. Submucous Fibroid
- A type of uterine leiomyoma located just beneath the endometrium.
- Protrudes into the uterine cavity.
- Causes:
- Heavy menstrual bleeding
- Dysmenorrhea
- Infertility and recurrent abortions (due to cavity distortion)
- Most symptomatic type of fibroid.
C. Subserous Fibroid
- A fibroid located beneath the serosal surface of the uterus.
- Grows outward into the pelvic cavity.
- Common effects:
- Pressure symptoms (urinary frequency, constipation)
- Usually does not cause infertility or heavy bleeding, since it does not distort the uterine cavity.
D. Uterine Septum
- A congenital Müllerian duct anomaly where a fibrous or fibromuscular septum divides the uterine cavity.
- Associated with:
- Recurrent miscarriages
- Infertility
- Preterm labor
- Diagnosed by ultrasound, MRI, or hysteroscopy.
Key clinical note
- Conditions that distort the uterine cavity (endometrial polyp, submucous fibroid, uterine septum) are commonly linked to infertility and recurrent pregnancy loss, whereas subserous fibroid usually is not.
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Writer: Vandita Singh,Lucknow (GS India Nursing Group