MRI evaluation of perianal fistulas and pelvic pain

One of the most common and challenging problems in clinical practice is determining the cause of pelvic pain. The differential diagnosis of pelvic pain is long and can include urogynecological, gastrointestinal, neurologic, or psychological, and abdominal wall causes. Ultrasound plays a central role as a primary imaging modality, especially in urogynecological disorders and CT/MRI allow further assessment of the pelvis for gastrointestinal and other pathologies. In this chapter, we will primarily discuss common gastrointestinal causes with a particular focus on perianal fistula and inflammatory bowel diseases. MRI can be critical in such situations. Gynecologic disorders associated with pelvic pain, including uterine endometriosis and adenomyosis, are addressed in other chapters of this book.