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No single test has adequate sensitivity and specificity to diagnose pelvic inflammatory disease. A large multisite U.S. study found that cervical motion tenderness as a minimum clinical criterion increases the sensitivity of the CDC diagnostic criteria from 83 percent to 95 percent.
Cervical motion tenderness or cervical excitation is a sign found on a gynecological pelvic examination suggestive of pelvic pathology.Classically, it is present in the setting of pelvic inflammatory disease (PID) or ectopic pregnancy and is of some use to help differentiate PID from appendicitis. [1]
Pelvic Inflammatory Disease (PID) Pelvic inflammatory disease—an infection of your uterus, fallopian tubes, or ovaries—is another inflammatory condition that can cause vaginal pain.
Pelvic abscess is a collection of pus in the pelvis, typically occurring following lower abdominal surgical procedures, or as a complication of pelvic inflammatory disease (PID), appendicitis, or lower genital tract infections. [1] Signs and symptoms include a high fever, pelvic mass, vaginal bleeding or discharge, and lower abdominal pain. [1]
“A thorough history, pelvic exam, urine pregnancy test, urine culture, STI testing, and pelvic ultrasound would help differentiate a diagnosis for the cause of unexplained cramping.”
Swabs can be used to collect a sample of this discharge for inspection under a microscope and/or lab testing for gonorrhea, chlamydia, and Trichomonas vaginalis. A bimanual exam in which the clinician palpates the cervix to see if there is any associated pain should be done to assess for pelvic inflammatory disease. [3]
Complications can result in pelvic inflammatory disease, difficulties bearing pregnancy, and endometriosis. Due to these adverse outcomes, the CDC recommends that women undergo routine nucleic acid amplification technique (NAAT) testing, which can aid in the detection of chlamydia and gonorrhea. [27]
Fitz-Hugh–Curtis syndrome occurs almost exclusively in women, though it can be seen in males rarely. [5] It is complication of pelvic inflammatory disease (PID) caused by Chlamydia trachomatis (Chlamydia) or Neisseria gonorrhoeae (Gonorrhea) though other bacteria such as Bacteroides, Gardnerella, E. coli and Streptococcus have also been found to cause Fitz-Hugh–Curtis syndrome on occasion. [6]