Question: I have been having intermittent bleeding in between periods, cramping, lower back pain, hip pain on right side, painful sex. I am 45 years old. I had an oblation in 2006. I had a transabdominal and transvaginal pelvic ultrasound. Findings: The uterus measures 8.5 cm in length, 6 cm in transverse and 5.5cm in Ap dimension. The uterus is retroverted. There is myometrial textural heterogeneity. This obscures the endometrial echo complex. Where visualized the endometrium measures 5 mm in maximal AP dimension. There is a 2cm featureless left ovarian cyst. The left ovary including the cyst measures 3 x 1.8 x 2.2 cm. the right ovary measures 2.5 x 2.4 x 1cm. There is no evidence for free fluid in the pelvis. Impression: There is myometrial textural heterogeneity. The differential diagnosis for this finding is small nondiscrete fibroids, ademyosis, as well as extremes of normal variation. Myometrial textural heterogeneity limits endometrial assessment. There is a 2cm featureless left ovarian cyst probably phisiologic in origin.