Rebecca is a 30-year-old nulligravid accountant who presents with four months of left-sided groin pain, intermittent dyschezia and deep dyspareunia.

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<p>Rebecca is a 30-year-old nulligravid accountant who presents with four months of left-sided groin pain, intermittent dyschezia and deep dyspareunia.</p><p>Rebecca is generally well with no systemic symptoms. She takes no regular medications, apart from pre-conception vitamins and NSAIDs regularly from two days prior through to day four of menses, which are regular.</p><p>This has been the case for the past two years since Rebecca stopped the oral contraceptive pill to start trying to conceive.</p><p>Urine pregnancy test is negative. Rebecca is afebrile, with localised left iliac fossa tenderness.</p><p>The GP requests a pelvic ultrasound, and the left adnexal findings are pictured.</p>

 Dr Kate Kelso is a GP and medical editor at Australian Doctor.