How to perform a gynaecological ultrasound in the paediatric or adolescent patient

Ultrasound is the first-line imaging modality in the assessment of the female reproductive system in all age groups. However, the paediatric and adolescent subset of patients present a particular set of challenges. These include technical challenges that come from largely being limited by transabdominal imaging as well as dealing with the often-complex social issues around the sexual health of adolescents. In addition, this group of patients has a unique set of pathologies that are not seen in the adult population and conversely, common gynaecological conditions affecting adults such as endometriosis and polycystic ovarian syndrome are difficult to diagnose in adolescents. Therefore, we propose that paediatric and adolescent gynaecological ultrasound requires a different approach. This paper summarises the differences in technique, common pathologies and touches on some of the relevant social issues that are unique to this population of patients.