Case 19 Answer: IUD related uterine perforationYes, this was a tough one but it was the whole reason for the X-ray and should be able to be...

Case 19 Answer: IUD related uterine perforation

Yes, this was a tough one but it was the whole reason for the X-ray and should be able to be diagnosed on the X-ray or US. However in this case the CT clearly shows the IUD outside the uterus

An IUD can tilt in all directions but it should always be midline in the pelvis. When you see it you should always assess if it could be in the uterus. 

ref: https://radiopaedia.org/articles/iucd-related-uterine-perforation?lang=us