Can adenomyosis be seen on ultrasound?

Yes—adenomyosis can often be suspected on transvaginal ultrasound, especially when the scan is performed and interpreted by clinicians experienced with adenomyosis patterns. Ultrasound doesn’t “see” the gland tissue directly, but it can show characteristic changes in the uterine muscle that strongly suggest adenomyosis. In focal cases, an adenomyoma can even look like a fibroid, which is why the details of the report matter.

That said, ultrasound isn’t perfect: adenomyosis can be missed, described vaguely, or reported as “borderline,” particularly in diffuse disease or when the imaging protocol and interpretation aren’t optimized. When the diagnosis is uncertain—or when treatment, fertility planning, or surgery decisions depend on greater clarity—MRI can be especially helpful to distinguish adenomyosis from fibroids and to map how deep and how widespread it appears. In our evaluation process, we combine your symptom story with expertly interpreted imaging to clarify what’s most likely driving your pain, bleeding, or fertility challenges, and you’re welcome to reach out to schedule a consultation with our team.