Gynecological pelvic infection: what is the role of imaging?

The diagnosis of pelvic infection is most often made clinically, based on a combination of pelvic pain and fever, and possibly a foul discharge. The patient is referred to radiology in two very different circumstances: either in the acute phase where the challenge is to differentiate a pelvic infection from appendicitis, urinary tract infection, and complications of a hemorrhagic luteal cyst; or some time after the infectious episode, which may have gone unnoticed, and the patient presents with an undetermined pelvic mass that needs to be characterized, where the challenge in that situation is not to confuse it with ovarian cancer. The signs and symptoms on the pelvic ultrasound, CT scan, and MRI suggest the correct diagnosis.