The Seasoned Sonographer

Uncovering AUB: From Ultrasound to Exam Room

Episode Summary

Abnormal uterine bleeding (AUB) is one of the most common reasons patients are referred for gynecologic ultrasound, yet it can be one of the most complex conditions to evaluate. In this episode of The Seasoned Sonographer, Lynn Flamm, RDMS, explores the clinical and imaging aspects of AUB and how sonographers can make a real difference in patient care. Special guest Physician Assistant Logan Colvis joins to share the provider’s perspective on evaluating AUB in the clinic. Together, they discuss the FIGO PALM-COEIN classification system, the role of ultrasound in identifying structural causes, and how providers integrate imaging findings into management decisions. Whether you’re a sonographer, student, or women’s health provider, this episode will give you practical insights, diagnostic pearls, and collaborative tips for approaching AUB from both the ultrasound room and the exam room.

Episode Notes

Topics covered in this episode:

Definition of Abnormal Uterine Bleeding (AUB) and why it matters

FIGO’s PALM-COEIN classification system (structural vs non-structural causes)

Sonographic evaluation of the endometrium: thickness, echotexture, and Doppler findings

Key ultrasound patterns of polyps, fibroids, adenomyosis, and hyperplasia

Postmenopausal bleeding and when endometrial thickness is concerning

How providers use ultrasound reports to guide treatment and biopsy decisions

Communication tips: explaining findings to patients without creating fear

Collaboration between sonographers and providers for best patient outcomes

Guest Interview Highlights:

Logan Colvis, PA shares real-world cases, diagnostic challenges, and the role ultrasound plays in shaping management decisions for women with AUB.

Takeaway Pearls:

Always measure and document endometrial thickness in the sagittal plane

Endometrial appearance must be interpreted in the context of age, cycle, and symptoms

Structural causes (polyps, fibroids, adenomyosis) have distinct ultrasound patterns

Clear sonographer reporting = better, faster, and safer patient care