As far as I know from midwife I used to work with is there can be 2 different conditions causing polycystic ovaries. PCOS and PCO (polycystic ovaries). PCO is a diagnosis of basically just problems with the ovaries such as cysts and trouble ovulating. PCOS includes problems with insulin resistence, acne, body hair and other hormonal imbalances
This website does a good job explaining that. It says, "Not all women with PCOS have polycystic ovaries (PCO), nor do all women with ovarian cysts have PCOS; although a pelvic ultrasound is a major diagnostic tool, it is not the only one. "