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