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Dystrophic calcification of the uterus results from prior tissue damage or necrosis, often linked to fibroids (leiomyomas), endometrial hyperplasia or carcinoma, chronic infections like tuberculosis or endometritis, surgical interventions, or pregnancy-related events such as retained products of conception. In a transabdominal ultrasound, a 3 to 4 mm calcification appears as a highly echogenic, bright spot within the myometrium or endometrium, accompanied by posterior acoustic shadowing. This shadowing occurs because the calcified area blocks the ultrasound waves, creating a dark area behind it. The overall uterine anatomy is also assessed. Transvaginal ultrasound offers higher resolution and shows the calcification as a very bright echogenic focus with characteristic posterior shadowing. This method allows for a detailed examination of the surrounding myometrium and endometrium, identifying any additional abnormalities or changes that might explain the presence of the calcification.