Pelvic Inflammatory Disease (PID)

Pain is usually felt in the pelvis, but this may be confused with the lower abdomen.

Maybe a history of vaginal discharge or dyspareunia (if she’s had sex since feeling ill)

Patients usually fell / appear ill.

  • Pt. with no tenderness on external abdominal palpation unlikely to have PID.

Main Finding: Cervical Motion Tenderness (CMT)

  • On pelvic bimanual, with fingers in vagina while conversing with pt., intermittently wiggle the cervix
  • Cervical Motion is very Tender.
  • DON’T ASK “does this hurt?”  Look for reaction each time you wiggle cervix.
  • Avoid abdominal pressure with external hand; simply wiggle cervix
  • Repeat several times to confirm with each wiggle