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Old 03-18-2011
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ObGyn Non-palpable ovary

I came across a test questions with a healthy 60 year old woman, non-obese, 63 inches talk, with atrophic external genitalia and small uterus, with one ovary 3x3 cm and the other non-palpable.

Do y'all have thoughts as to what condition she suffers from? I was thinking possibly Turners.
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Old 03-19-2011
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Originally Posted by healer2b View Post
I came across a test questions with a healthy 60 year old woman, non-obese, 63 inches talk, with atrophic external genitalia and small uterus, with one ovary 3x3 cm and the other non-palpable.

Do y'all have thoughts as to what condition she suffers from? I was thinking possibly Turners.
normally the ovaries are NOT palpable. They could be in a thin premenopausal woman. Overall the palpable ovarian lesion is suspicious for ovarian carcinoma until proven otherwise. Do an US to define the nature of the lesion (mass or cystic) and of course do a thorough history to exclude any benign conditions such as chocolate cysts.
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Old 03-19-2011
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Thanks tkourkou,

I found the following from another forum: Normally, on physical examination, the ovaries are 2-3 cm in young women and not palpable in postmenopausal women.

My understanding is that ovaries are palpable until menopause. Do you agree.
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Old 03-19-2011
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Thanks tkourkou,

I found the following from another forum: Normally, on physical examination, the ovaries are 2-3 cm in young women and not palpable in postmenopausal women.

My understanding is that ovaries are palpable until menopause. Do you agree.
I disagree. You should have a raised suspicion and should never rely on a "normal" palpated ovary! An ultrasound has a much much higher sensitivity and specificity than manual examination!
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Old 03-19-2011
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According to Mosby's Guide to the Physical Exam, the ovaries, if palpable, should feel firm, smooth, ovoid and approximately 3x2x1 cm in size. A 1988 study by Granber and Wikland found that only 13 % of premenopausal women (and 70% of postmenopausal women) had impalpable ovaries.

During an annual gyn exam for a 25 year old non-obese woman, the ovaries are likely to be palpable and if they are of normal size, no further investigation needs to be done. However in the case of this post-menopausal woman with a palpable 3x3 cm ovary, particularly in the setting of a nonpalpable contralateral ovary, she should clearly be worked up with an ultrasound.

It probable that the ever-increasing obesity in the US and other countries combined with the general decline in physical exam skills, physicians are less and less able to palpate the ovaries of healthy women. Still a firm, smooth, ovary approximately 3x2x1 cm in size palpated in a thin premenopausal woman should not be cause for alarm.
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