Question 1744
{"accessible":false,"alternatives":[{"id":8665,"text":"chevron sign"},{"id":8666,"text":"drooping moustache sign"},{"id":8667,"text":"loss of H or W shape of vagina"},{"id":8668,"text":"saddlebag bladder sign"}],"archived":false,"correctAlternativeId":8666,"explanation":"\u003cp\u003eThe endopelvic fascia cannot be seen on imaging, but damage to the fascia can be inferred by the presence of various signs. The upper third of the vagina usually has a horizontal appearance, but in the event of damage to the level 1 fascia, the lateral support is lost and the vagina may have an inverted V shape, known as the\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/chevron-sign-endopelvic-fascial-defect?lang=gb\"\u003echevron sign\u003c/a\u003e. The middle third of the vagina usually has a H or W shape on axial imaging, and loss of the level 2 fascia along with puborectalis dehiscence, may lead to loss of the normal shape on one or both sides. Loss of the paravaginal ligaments leads to loss of support of the posterolateral aspect of the bladder and the\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/saddlebag-bladder-sign-endopelvic-fascial-defect?lang=gb\"\u003esaddlebag bladder sign\u003c/a\u003e.\u0026nbsp;Damage to the pubovesical ligaments and rectovaginal fascia may also lead to the development of\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/cystocele?lang=gb\"\u003ecystoceles\u003c/a\u003e\u0026nbsp;and\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/rectocele-1?lang=gb\"\u003erectoceles\u003c/a\u003e, respectively. Finally, damage to the level 3 fascia and the periurethral ligaments leads to posterior drooping of the lateral corners of the retropubic fat, leading to the\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/drooping-moustache-sign-endopelvic-fascial-defect?lang=gb\"\u003edrooping moustache sign\u003c/a\u003e.\u003c/p\u003e","id":1744,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/1744","nextQuestionPath":null,"relatedArticles":[{"id":81516,"title":"Endopelvic fascia","link":"/articles/endopelvic-fascia?lang=us"},{"id":81521,"title":"Drooping moustache sign (endopelvic fascial defect)","link":"/articles/drooping-moustache-sign-endopelvic-fascial-defect?lang=us"},{"id":81524,"title":"Chevron sign (endopelvic fascial defect)","link":"/articles/chevron-sign-endopelvic-fascial-defect?lang=us"}],"alsoUsedIn":[{"id":233,"kind":"Course","title":"Pelvic Floor Imaging","link":"https://radiopaedia.org/courses/pelvic-floor-imaging"},{"id":792,"kind":"Course","title":"Lectures by Vikas Shah - page 792","link":"https://radiopaedia.org/courses/lectures-by-vikas-shah/pages/792"},{"id":1197,"kind":"Course","title":"Abdominal Lectures - page 1197","link":"https://radiopaedia.org/courses/abdominal-lectures/pages/1197"}],"stem":"\u003cp\u003eWhich of these signs is caused by damage to the level 3\u0026nbsp;endopelvic fascia?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1744"}],"attemptsPercentages":[{"alternativeId":"8667","percentage":13},{"alternativeId":"8668","percentage":10},{"alternativeId":"8666","percentage":71},{"alternativeId":"8665","percentage":6}],"promptToLogin":false,"questionManager":false,"articleId":"saddlebag-bladder-sign-endopelvic-fascial-defect"}