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

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.