<prompt> Kamla, a 30 yrs old lady examined for infertility by hysterosalpingography, reveals Bead-like fallopian tube and clubbing of ampulla. Most likely cause is:GonococcusMycoplasmaChlamydiaMycobacterium tuberculosis  <response>: Ans. is d, i.e. Mycobacterium tuberculosisRef: Shaw 15thed, pl57The following findings on hysterosalpingogram strongly suggest tubercular salpingitis: A rigid nonperistaltic pipe like tube, called lead pipe appearanceQ Beading and variation in filling densityQ Calcification of the tubeQ Cornual blockQ A jagged fluffiness of the tubal outlineQ Vascular or lymphatic intravasation of the dyeQ Tobacco-pouch appearance seen on naked eye examination.Also Note: In a proven case of genital tuberculosis, hysterosalpingography is contraindicated as it may spread the infection. In TB Endometritis on HSG: The uterine cavity is shrivelled and obliterated by adhesions giving honeycomb appearance. On USG: Incomplete septation of the tubal wall Cogwheel sign is a marker for acute disease. Thin wall and beaded string appearance is a marker for chronic disease. 