The initial step in managing fibroids involves accurate Diagnosis Methods to determine the number, size, and precise location of the growths, which dictates the appropriate treatment pathway. Ultrasonography, utilizing both abdominal and transvaginal approaches, is the preferred first-line imaging modality due to its safety, wide availability, and effectiveness in visualizing the uterus and detecting fibroids. Transvaginal ultrasound offers high sensitivity, especially for small or intramural fibroids, while supplemental techniques like sonohysterography (saline-infusion sonogram) enhance the visualization of submucosal fibroids within the uterine cavity.

When treatment planning requires greater detail, particularly before minimally invasive procedures like Uterine Fibroid Embolization (UFE) or MR-guided Focused Ultrasound (MRgFUS), Magnetic Resonance Imaging (MRI) is often utilized. MRI provides superior soft tissue contrast, which is essential for differentiating fibroids from other masses and accurately mapping the fibroid-to-myometrium border. Diagnostic hysteroscopy, involving the insertion of a slender telescope through the cervix, allows for direct visualization and removal of submucosal fibroids, completing the diagnostic spectrum from non-invasive screening to detailed procedural planning.

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