This document discusses various genitourinary signs seen on imaging studies. It describes the "Bear's paw sign" seen with xanthogranulomatous pyelonephritis and the "Onion ring appearance" seen with testicular epidermoid tumors. It also mentions the "Koala bear sign" seen with pelvic inflammatory disease and tubo-ovarian abscesses, as well as kissing ovaries seen with pelvic endometriosis. Deep pelvic endometriosis and locations of utricle cysts and Mullerian duct cysts are also outlined.

1. Genitourinary
Dr Dalia El Said, MD
General organization for teaching Hospitals and Institutes.

2. Bear’s paw sign
Xanthogranulomatous
pyelonephritis

3. Onion ring appearance
Testicular epidermoid

4. Koala bear sign
Pelvic inflammatory disease
Uterus
UB

5. Koala bear sign
Pelvic inflammatory disease
( tubo-ovarian abscesses)
Uterus

6. Kissing ovaries
Pelvic endometriosis (The
sign caused by pelvic adhesions)

7. Deep pelvic endometriosis
Torus uterinus.
(site of attachment of
uterosacral ligaments to the
uterus).
Uterosacral
ligaments.
Dome of the
bladder.

8. Peritoneal inclusion cyst / pseudocyst.
Multi- loculated fluid collection conforming to the peritoneal space and enclosing the ipsilateral
normal ovary (Arrow).

10. Prostatic cysts

11. Prostatic cysts
Utricle cyst
- Midline.
- Communicate with the
urethra.
Müllerian duct cyst.
- Extend above the prostate
•- M.B lateral to the midline.
•- They do not communicate
with the urethra