CASE REPORT
ARCUATE UTERUS IDENTIFIED ON PELVIC MRI:A NORMAL VARIANT MIMICKING SEPTATE UTERUS

UDK: 618.14-073.756.8:

MitreskaJ.A.1,2, Nedev S.1,2, Nikolova S.1,2

1Institute of Radiology, Skopje, Republic of North Macedonia

2Faculty of Medicine,Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia

Nikolova Sonjahttps://orcid.org/0000-0001-6681-1453
Josifoska Mitreska Angelahttps://orcid.org/0009-0000-2994-6770

Abstract

Background: Accurate differentiation of Müllerian duct anomalies is a critical component of infertility assessment. A septate uterus is associated with adverse reproductive outcomes and often requires surgical correction, whereas an arcuate uterus is considered a benign anatomical variant with no proven clinical significance. Magnetic resonance imaging (MRI) offers superior characterization of uterine morphology, enabling precise diagnosis.

Case Presentation: A 35-year-old woman undergoing infertility evaluation was referred for pelvic MRI due to a suspected septate uterus. MRI demonstrated a normal external uterine fundal contour with a smooth, broad concave indentation of the endometrial fundus measuring less than 1 cm. No fibrous septum or cavity division was identified, findings consistent with an arcuate uterus. Both ovaries were normal, and a small amount of physiologic pelvic free fluid was present.

Conclusion: This case underscores the pivotal role of MRI in distinguishing an arcuate uterus from a septate uterus during infertility work-up. Accurate imaging diagnosis prevents unnecessary surgical intervention and allows appropriate reproductive counseling.

Keywords: Arcuate uterus; Infertility; Müllerian duct anomalies; Pelvic MRI; Septate uterus

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