Not only appendicitis! Transabdominal ultrasound detects a variety of pathology in the iliac fossae

Patients presenting with iliac fossae pain are common cases in Emergency Departments. The clinical picture for a wide variation of pathologies is often non-specific and encompasses a wide differential diagnosis, resulting in a diagnostic dilemma. Ultrasound (US) is usually the first imaging examination to be performed. Its use for diagnosing acute appendicitis has already been proved, however it is also useful for most of the pathological entities in this area. US is practical, safe, cheap and plays an important role in the recognition, diagnosis and monitoring of many gastrointestinal and gynaecological diseases located in the iliac fossae. In this pictorial essay, we present cases in which US was used to diagnose appendicitis, Crohn’s disease, diverticulitis, pelvic abscess, epiploic appendagitis, inguinal hernia, intussusception, pelvic congestion syndrome, ovarian torsion, haemorrhagic ovarian cyst, ectopic pregnancy, iliac fossa haematoma, mesenteric adenitis, Meckel’s diverticulum complications, omental infarction and ileocaecal tuberculosis. We focus on highlighting the use of US for imaging pathology in the iliac fossae and assess its role in comparison to plain radiographs, computed tomography and magnetic resonance, when these modalities are performed.