What finding would you expect on a physical examination of a patient with adenomyosis?

A globular, boggy uterus is a characteristic finding in patients with adenomyosis. Adenomyosis is a condition where endometrial tissue exists within the muscular wall of the uterus, leading to thickening of the uterine walls and often resulting in an enlarged, soft, and indistinctly defined uterus. During a physical examination, this may present as a uterus that feels enlarged and has a boggy texture, which is different from the firmer or more distinct findings noted in other conditions affecting the uterus.

In contrast, a firm, non-tender uterus would typically suggest conditions such as fibroids or normal pregnancy, where the uterine tissue is not affected by the infiltration of endometrial tissue. An enlarged ovary is more indicative of ovarian pathologies such as cysts or tumors rather than adenomyosis, which primarily involves the uterus. Lastly, a small, mobile uterus is often seen in cases where there are no underlying pathologies, indicating normal anatomy and function, and does not correlate with the uterine changes associated with adenomyosis. Therefore, the finding of a globular, boggy uterus aligns closely with the pathophysiological changes seen in adenomyosis.