Sometimes. The true diagnosis of endometriosis requires a biopsy and a pathologist to confirm the diagnosis. Almost all the time this requires an abdominal procedure, commonly laparoscopy. However, some women may have nodules of endometriosis in the vagina, for instance, that can be biopsied in the office to prove endometriosis. Usually this is a bad prognostic sign.
Yes but not accurate. Laparoscopy is the gold standard for the diagnosis of endometriosis. Some endometriomas which is endometriosis inside of the ovaries containing old blood can be seen on ultrasound and mri. Occasionally on physical examination endometriosis can be found behind the uterus and the bladder on palpation.