Young Female with Sudden Onset Pelvic Pain

This is a bit of a different case. I will present the stem and then we will go through the DDx based on bHCG and  US findings. 

So the case:

22yo female has sudden onset RIF pain while out jogging. Pain is severe and she had one vomit at the Tan. She thought she had pulled a muscle while running so went home and had a shower. Coming out of the shower she almost had a syncope but managed to lower herself to the floor. 

She has presented to emergency with a friend. 

She has no past medical history. Nil previous pregnancies.  No previous episodes of pelvic pain. Usually has mild pain only with menstruation. She cannot recollect the dates of her LMP but believes it is probably due soon. Not being on the OCP her cycles vary 4-6 weeks. 

Obs: Hr 85 BP 120/60 sats 100 RR 14 afebrile

She is given a cat 3 at triage and given a urine pot for a sample. 

This is her Pelvic and RUQ US:

Click on the buttons below to see US findings based on bHCG