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Can You See Endometriosis on an Ultrasound?

Reviewed by Fairbanks Ultrasound Team

Advanced Diagnostic Imaging for Women’s Health at Fairbanks Ultrasound

Understanding Endometriosis: What Is It?

Endometriosis is a common but often misunderstood condition that affects approximately 1 in 10 women of reproductive age. It occurs when tissue similar to the lining of the uterus (the endometrium) grows outside the uterus. These growths can attach to the ovaries, fallopian tubes, bladder, bowel, and other pelvic organs, causing inflammation, pain, and scar tissue.

Symptoms of endometriosis can vary widely but may include:

Pelvic pain, especially during menstruation

Painful intercourse

Painful bowel movements or urination

Heavy or irregular menstrual bleeding

Infertility or difficulty getting pregnant

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If you’re experiencing any of these symptoms, you might be wondering: can you see endometriosis on an ultrasound?

Can Endometriosis Be Detected by Ultrasound?

The Short Answer: Sometimes

Ultrasound is one of the most common and accessible diagnostic tools available. However, not all types of endometriosis are visible on an ultrasound, especially the more subtle or surface-level lesions. That said, ultrasound can be highly effective for identifying certain types of endometriosis, particularly when performed by skilled technologists using specialized techniques.

What Can Be Seen on an Ultrasound?

1. Endometriomas (Ovarian Endometriosis Cysts)

Endometriomas are cysts that form when endometrial-like tissue grows on the ovaries. These cysts, often called “chocolate cysts” due to their thick, dark content, are typically visible on a transvaginal ultrasound. They appear as fluid-filled sacs with distinctive internal echoes or patterns that an experienced sonographer can recognize.

2. Deep Infiltrating Endometriosis (DIE)

Deep infiltrating endometriosis refers to lesions that extend into surrounding pelvic structures, including the rectovaginal septum, uterosacral ligaments, bladder, and bowel. With advanced imaging protocols and expertise, ultrasound can sometimes detect these deeper nodules or abnormalities in organ positioning and mobility. At Fairbanks Ultrasound, we utilize dynamic pelvic ultrasound techniques, such as "sliding sign" and organ mobility assessments, which may reveal indirect signs of deep pelvic endometriosis.

3. Pelvic Adhesions and Distorted Anatomy

Chronic endometriosis can lead to scarring and adhesions that pull pelvic organs out of their normal position. While adhesions themselves aren’t always directly visible, ultrasound may detect changes in organ structure or restricted mobility that suggest the presence of adhesions.

Limitations of Ultrasound in Diagnosing Endometriosis

Despite the value of ultrasound, it’s important to recognize its limitations:

  • Small or superficial endometrial implants on the peritoneal lining often go undetected.
  • The absence of visible cysts or nodules does not rule out endometriosis.
  • A normal ultrasound report may still warrant further testing if symptoms persist.
Can You See Endometriosis on an Ultrasound?

That’s why endometriosis is often diagnosed based on a combination of symptom history, physical examination, imaging findings, and in some cases, laparoscopic surgery, which remains the gold standard for diagnosis.

Why Choose Fairbanks Ultrasound for Endometriosis Imaging?

At Fairbanks Ultrasound, we’re committed to helping patients get accurate, timely answers when facing unexplained pelvic pain or suspected endometriosis. Here’s what sets us apart:

Specialized Women’s Health Imaging

Our technologists are trained in the latest protocols for gynecologic imaging, with a focus on detecting signs of endometriosis and other complex pelvic conditions.

High-Resolution Transvaginal and Transabdominal Ultrasound

We use state-of-the-art ultrasound technology to maximize image clarity and diagnostic potential.

Collaboration with Referring Providers

We work closely with OB/GYNs, fertility specialists, and primary care providers to support a comprehensive care plan for every patient.

Fast and Convenient Scheduling

We offer same-day and next-day appointments for urgent cases, helping you avoid unnecessary delays in your care.

What Happens After Your Ultrasound?

After your exam, our expert imaging team will promptly review the results and forward them to your referring provider. If ultrasound findings suggest endometriosis—or if your symptoms continue without a clear cause—your provider may recommend additional imaging such as an MRI or laparoscopy to confirm a diagnosis.

Schedule Your Pelvic Ultrasound in Fairbanks, AK

If you’ve been struggling with pelvic pain, irregular cycles, or fertility issues and are asking yourself, “can you see endometriosis on an ultrasound?”, the team at Fairbanks Ultrasound is here to help.

Getting an ultrasound is a non-invasive, affordable first step in evaluating endometriosis and other gynecological concerns. Our team combines medical expertise with compassionate care to guide you toward the answers you deserve.

Call today to schedule your appointment or request more information.
Serving Fairbanks and surrounding communities across Interior Alaska.