Imaging of questionable and unusual pelvic masses.

Ultrasonography is usually the initial diagnostic examination performed for evaluating gynaecological conditions and pelvic masses. The authors' experience with 11 "problem cases" and a review of the literature of such enigmas has led to the following recommendations in the following order: a plain radiograph or repeat ultrasound study; ultrasound study with the water enema technique; gastrointestinal examination if the answer is still not apparent, followed by computed tomography or a real-time ultrasound study during a clinical pelvic examination.