The edition · Radiology
Postmenopausal pelvic pain starts with ultrasound, and trauma CT should fit the patient
Updated ACR criteria for acute pelvic pain after menopause and for biliary cancer staging, European recommendations to tailor whole-body trauma CT, and a small study of MRI for abductor tears after hip replacement.
The edition in brief
Today's radiology edition. The 2026 update of the ACR Appropriateness Criteria for acute pelvic pain in postmenopausal women keeps ultrasound as the first test, with MRI or CT when ultrasound is inconclusive, and stresses that causes in this age group present atypically and carry more risk of malignancy. Separate ACR criteria for biliary cancer place contrast-enhanced CT and MRI at the centre of local staging, with chest, abdomen and pelvis CT and FDG-PET for distant disease and follow-up. European emergency radiologists recommend whole-body trauma CT protocols chosen by haemodynamic state and mechanism rather than one fixed protocol, radiologists embedded in the trauma team, and checklist-based reporting. In 36 patients having revision surgery after lateral-approach hip replacement, MRI identified surgically confirmed abductor tendon tears with sensitivity and specificity of about 0.86 to 1.00. The pearl is a reminder that preserved Doppler flow does not exclude ovarian torsion.
ACR biliary cancer criteria: CT and MRI for local staging, PET for distance
Stage biliary cancer with contrast-enhanced CT or MRI locally and chest-abdomen-pelvis CT or FDG-PET for distant disease.
Whole-body trauma CT should be matched to physiology and mechanism
Choose the whole-body trauma CT protocol by physiology and mechanism, and report with a checklist and a defined route for critical findings.
MRI picked up abductor tendon tears after lateral-approach hip replacement
MRI with metal artefact reduction can identify abductor tendon tears after lateral-approach hip replacement; report defects, peritrochanteric fluid and atrophy.
Normal Doppler flow does not exclude ovarian torsion
When torsion is suspected, report ovarian size and the pedicle, not just Doppler flow.
Acute pelvic pain after menopause: ultrasound first, with a lower threshold for concern
Image acute postmenopausal pelvic pain with ultrasound first, and read adnexal findings with a higher suspicion of malignancy than in younger women.
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