Table 4 Work-up for adenomyosis.

Measure/investigation	Finding
Past medical history	Dysmenorrhea (including with neurodystonia), hypermenorrhea
Clinical examination	Occasionally tender, enlarged uterus (bimanual, rectovaginal palpation)
Transvaginal ultrasound	Poorly demarcated heterogeneous areas, cystic intramural changes in some cases, areas of variable echogenicity, irregular halo effect, discrepancy between anterior and posterior wall
MRI	Changes in the zonal anatomy of the uterus, Irregular junctional zones on T1- and T2-weighted images, areas of low signal intensity and subendometrial foci of high signal intensity, anterior-posterior wall asymmetry as a sign of muscle hyperplasia