In genital tuberculosis, which part of the female genital tract is MOST commonly affected, and what is the characteristic HSG finding?
- A Ovary — most common; HSG shows frozen pelvis
- B Endometrium — most common; HSG shows irregular filling defects
- C Fallopian tube — most common (95–100%); HSG shows beaded tubes, 'rat-tail' appearance, calcification, or 'golf-hole' cornual occlusion ✓
- D Cervix — most common; HSG shows cervical stenosis
Correct answer: C. Fallopian tube — most common (95–100%); HSG shows beaded tubes, 'rat-tail' appearance, calcification, or 'golf-hole' cornual occlusion
Explanation
The fallopian tubes are affected in virtually all cases (95–100%) of genital tuberculosis and are the primary site of infection. HSG in genital TB can show beaded or irregular tubes, 'pipe-stem' or 'golf-hole' cornual occlusion, tubal calcifications, and irregular uterine cavity (when endometrium is involved — Asherman-like pattern). The endometrium is affected in approximately 50% of cases. Diagnosis requires histology (caseating granuloma) or culture/NAAT.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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