Pathophysiology: Adenomyosis is histologically defined by the presence of ectopic endometrial tissue within the myometrium. Benign invasion of the myometrium by the endometrium also results in adjacent smooth muscle hyperplasia.
Role of MRI: MRI is the modality of choice to diagnose and characterize adenomyosis, and T2 WI are most useful. The most important feature is thickening of the junctional zone of the uterus to more than 12 mm (normal junctional zone measures no more than 5 mm). 
Clinical details: This patient presented with menorrhagia and dysmenorrhea and MRI revealed grossly thickened junctional zone.  

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