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Updated: Dec 10, 2025

A Coregistered Ultrasound and Photoacoustic Imaging Protocol for the Transvaginal Imaging of Ovarian Lesions
Published on: March 3, 2023
The Flipped Ovary Sign in Ovarian Torsion
Mark D Sugi1, Anika G Patel2, Johnny Yi3
1Department of Radiology and Biomedical Imaging, Division of Abdominal Imaging and Ultrasound, University of California, San Francisco, California, USA.
Abstract:
The diagnosis of ovarian torsion is challenging and relies mostly on morphologic findings. Occasionally, women or children with acute pelvic pain who have undergone an initial ultrasound (US) evaluation with results interpreted as negative for ovarian torsion will return with recurrent or increasing pain, prompting an US reevaluation. The flipped ovary sign refers to a demonstrable change in the orientation of the ovary on follow-up US examinations, recognized by changing positions of ovarian landmarks established by follicles, cysts, or masses. This sign is valuable for identifying ovarian torsion in these patients, even in the absence of classic morphologic or Doppler features of ovarian torsion.
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