Pelvic Congestion Syndrome: Classic Radiologic Features and Diagnostic Considerations

Pelvic congestion syndrome (PCS), also known as pelvic venous disease, is a lesser known but relatively common cause of pelvic pain in female patients and is estimated to be responsible for 30% of chronic pelvic pain. Diagnosis of PCS is challenging due to multiple factors, including the diverse nature of pelvic pain, the appearance of pelvic venous congestion in imaging examinations of asymptomatic female patients, its status as a diagnosis of exclusion, and the physiologic limitations of anatomic imaging. This article reviews potential etiologies and key diagnostic imaging features of PCS to help radiologists recognize this disease and usher symptomatic patients into appropriate treatment pathways.