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Often ultrasound is used as an initial screening tool to identify potential etiologies of dysmenorrhea, renal or reproductive tract abnormalities and adnexal masses with endometriomas. Sometimes a linear probe can be helpful to enhance resolution transabdominally. You could try a 3D probe transabdominally to try and gain more information. Often in clinically warranted cases, the patient may be referred for an MRI. These are often a difficult subset of patients who quite often have delayed diagnosis and treatment.