Pediatric Polycystic Ovarian Syndrome

• Etiology: Chronic anovulation syndrome associated with androgen excess
• Imaging US: Ovaries are enlarged and have increased number of follicles (which measure 2-9 millimeters in size) with follicle number per ovary greater than or equal to 20 in at least one ovary
• Note: Ultrasound should not be used for the diagnosis in patients less than 8 years after menarche due to the high incidence of multi-follicular ovaries at this age
• DDX: Causes of androgren excess: congenital adrenal hyperplasia, Cushing syndrome, androgen-secreting tumor
• Complications: At risk for ovarian hyperstimulation syndrome when undergoing in-vitro fertilization
• Treatment:
• Clinical:
  — Classic triad is oligomenorrhea and or anovulation and hirsutism and obesity
  — May have infertility and acne and alopecia and increased androgen levels
  — Rotterdam criteria used to make diagnosis which requires two of three criteria for diagnosis: ovulatory dysfunction, clinical and-or biochemical signs of hyperandrogenism, polycystic ovarian morphology on ultrasound or elevated serum anti-Mullerian hormone

Radiology Cases of Polycystic Ovarian Syndrome