**Imaging Modality:** Hysterosalpingogram (HSG); fluoroscopic contrast study. **Anatomical Region:** Female pelvis, specifically the uterus and fallopian tubes. **Observed Pathology:** Intrauterine synechiae (Asherman syndrome). **Characteristic Visual Features:** The image demonstrates a hysterosalpingogram showing the uterine cavity opacified with radiopaque contrast media. The uterine contour is highly irregular and distorted. Key findings include multiple well-defined, linear, and irregular radiolucent filling defects within the contrast-filled uterine body. These filling defects represent intrauterine adhesions or synechiae that bridge the uterine walls, preventing uniform contrast distribution. **Differentiating Features:** The presence of sharp, angular, and non-mobile filling defects distinguishes synechiae from air bubbles (which are typically rounded and mobile) or endometrial polyps and fibroids (which usually present as smooth, rounded intraluminal masses). There is limited visualization of normal cornual anatomy, and no definitive bilateral tubal spillage is observed in this view, suggesting significant cavitary obliteration.

This monochrome diagnostic clinical image captures a hysteroscopic view of an intrauterine adhesiolysis procedure. The visual field demonstrates intrauterine adhesions, also known as Asherman Syndrome, appearing as cloudy, whitish, irregular fibrous bands and bridges of tissue within the uterine cavity. The surrounding endometrial tissue exhibits a granular, darker texture. A polished, reflective metallic hysteroscopic scissor is actively engaged in 'cold-knife' dissection of the adhesive structures. The instrument has a slim, sharp-edged profile designed for precise mechanical cutting without the use of electrosurgical energy, thereby minimizing thermal damage to the residual endometrium. This procedural image illustrates a key surgical intervention for restoring uterine cavity morphology to address symptoms such as infertility, amenorrhea, or cyclic pelvic pain.

This diagnostic and interventional hysteroscopy image consists of two panels demonstrating intrauterine adhesions (Asherman syndrome) within the uterine cavity. The left panel shows the mid-uterine cavity with reddish-pink endometrial lining and whitish, fibrous tissue bands stretching across the lumen. A metallic grasping instrument with a textured surface is visible, engaging with the adhesions. The right panel provides a closer view of dense, opaque, avascular synechiae bridging the uterine walls. These adhesions partially obliterate the cavity, characteristic of moderate-to-severe intrauterine scarring. Surgical microscissors or grasping forceps are seen in the foreground, indicating the therapeutic lysis of these adhesions. The images serve to illustrate the visual appearance of fibrotic bands and the use of hysteroscopic instrumentation in the treatment of infertility related to endometrial pathology.

This clinical diagnostic image is a hysteroscopic view of the uterine cavity during a surgical adhesiolysis procedure. The image depicts intrauterine adhesions (Asherman syndrome) characterized by thick, whitish, fibrous bands and opaque web-like structures bridging the uterine walls. The background shows the healthy pinkish-red mucosal lining of the endometrium and visible branching blood vessels. A dark gray, thin, 5-Fr surgical scissor is positioned within the frame, actively engaging with the dense adhesions to restore the normal volume and architecture of the uterine cavity. The educational focus of this image is the visual identification of intrauterine synechiae and the procedural technique of hysteroscopic lysis in a patient with infertility or recurrent pregnancy loss.

A 3D coronal plane ultrasound image of a human uterus, demonstrating the standard protocol for assessing congenital uterine anomalies (CUAs). The image features four key quantitative measurements used to differentiate between normal, arcuate, and septate morphologies. Line 1 (3.08 cm) represents the interostial line, connecting the interstitial portions of the fallopian tubes. Line 2 (2.98 cm) is a parallel reference along the serosal surface of the fundus. Measurement 3 (0.96 cm) indicates the uterine wall thickness, calculated as the vertical distance between the serosal surface and the interostial line. Measurement 4 (0.40 cm) quantifies the internal fundal indentation depth from the interostial line. The external fundal contour is smooth with no significant cleft, ruling out a bicornuate (U3) classification. The mild internal indentation of 0.40 cm is consistent with an arcuate uterus or a normal variant, as it does not meet the ESHRE/ESGE or ASRM criteria for a septate uterus. This diagnostic imaging is essential in reproductive medicine for evaluating Mullerian duct anomalies and fertility.

This diagnostic image is a 3D ultrasound of the uterus in the coronal plane, specifically reconstructed to evaluate congenital uterine anomalies. The image demonstrates a septate uterus, characterized by a significant internal midline indentation of the uterine fundus that divides the upper endometrial cavity into two horns while maintaining a relatively flat or minimally indented external serosal contour. Caliper measurements are visible for diagnostic classification: marker '1' measures the fundal indentation depth at 1.73 cm (17.3 mm), and marker '2' measures the inter-cornual distance at 3.79 cm. These measurements are critical for applying diagnostic criteria such as ESHRE-ESGE, ASRM, and CUME to differentiate between septate, bicornuate, and arcuate uterine morphologies. The educational focus is on identifying internal cavity architecture and utilizing specific measurement thresholds (e.g., indentation >10-15mm) to classify Mullerian duct anomalies in reproductive medicine.

This diagnostic image is a 3D coronal ultrasound reconstruction of a human uterus, specifically highlighting a congenital uterine anomaly. The visual demonstrates a septate uterus, characterized by a prominent internal fundal indentation that divides the superior portion of the uterine cavity into two sections. Visible electronic calipers and numbered annotations (1–4) mark critical anatomical measurements used for classification according to ESHRE-ESGE and ASRM criteria. Measurement 1 (1.73 cm) indicates the depth of the fundal indentation, while Measurement 4 (0.90 cm) assesses the uterine wall thickness, resulting in a high indentation-to-wall-thickness (I:WT) ratio of 192%. The external fundal contour remains relatively flat or convex, a key feature distinguishing the septate uterus from a bicornuate uterus. This educational visual is used in reproductive medicine and radiology to teach the standardized assessment of Müllerian duct anomalies, focusing on the differentiation between septate, subseptate, and arcuate uterine morphologies through quantitative morphometric analysis.