Fallopian tube disease in the nonpregnant patient

The increasing use of imaging necessitates familiarity with a wide variety of pathologic conditions, both common and rare, that affect the fallopian tube. These conditions should be considered in the differential diagnosis for pelvic disease in the nonpregnant patient. The most common condition is pelvic inflammatory disease, which represents a spectrum ranging from salpingitis to pyosalpinx to tubo-ovarian abscess. Isolated tubal torsion is rare but is nevertheless an important diagnosis to consider in the acute setting. Hematosalpinx in a nonpregnant patient can be an indicator of tubal endometriosis; however, care should be taken to exclude tubal torsion or malignancy. Current evidence suggests that the prevalence of primary fallopian tube carcinoma (PFTC) is underestimated and that there is a relationship between PFTC and breast cancer. PFTC has characteristic imaging features that can aid in its detection and in differentiating it from other pelvic masses. Familiarity with fallopian tube disease and the imaging appearances of both the normal and abnormal fallopian tube is crucial for optimal diagnosis and management in emergent as well as ambulatory settings.