THE PLAIN roentgenogram is the first step in the radiological evaluation of a gynecologic disorder. The bladder should be empty. Displacement of intestinal gas may be the clue to the presence of a pelvic mass. Except for vascular calcification, uterine leiomyoma constitutes the most common cause of pathological pelvic calcification. Subserosal and intramural myomas calcify more frequently than the submucosal variety. The calcification is typically flocculent, patchy, and coalescent (Fig 1), varying in size from tiny punctate deposits to large calcific masses. Occasionally, a uterine myoma may present with arcuate calcification, which must then be differentiated from a cystic lesion or an aneurysm.
The plain roentgenogram is often helpful in detecting dermoid cysts of the ovary. About one third of such cysts contain dentigerous elements, thereby permitting a definitive diagnosis. Bone may be identified in about a fourth of the cases, frequently in association with teeth.1 A circumscribed radiolucent image,
Stern WZ. Gynecologic Radiology. JAMA. 1977;238(16):1763-1765. doi:10.1001/jama.1977.03280170057034