The anteverted and mobile uterus is normal in size and echogenicity. There is a normal midline secretory type endometrial echo measuring 10 mm.
The right ovary measures 43 x 17 x 42mm, volume 16cc and ismobile and non tender. There are multiple small follicles within.
The left ovary measures 62 x 39 x 41mm, volume 52cc. The ovary demonstrates reduced mobility, and is tender on scanning. There was a large 4.8cm complex cystic structure, with some internal linear echoes that appears to arise from the left ovary. This hypoechoic structure is separate to the dilated, fluid filled left fallopian tube. This complex cystic structure was not present on the pelvic ultrasound from 3 years prior.
The left fallopian tube is dilated and fluid-filled, measuring up to 2 cm in maximum diameter. The tube measures a length of approximately 7 cm. At the fimbrial end of the tube, immediately adjacent to the left ovary, lies the aforementioned 4.8 cm hypoechoic structure. Mild tenderness is elicited when scanning over the tube.
Crossed fused ectopia of the left kidney again noted.
Conclusion
Left hydrosalpinx and complex hypoechoic mass almost certainly arising from the left ovary in keeping with tubo-ovarian abscess.