Women with Endometritis feel ill (like bona fide PID).
- If no tenderness on external abdominal palpation, the Dx is unlikely
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
Uterine Fibroids usually present with heavy menstrual bleeding, plus-or-minus dysmenorrhea. Pure pain from fibroids is a chronic, low-grade discomfort.
- Acute degeneration or torsion, both uncommon, may mimic endometritis. Dx is difficult, since serious abdominal / pelvic infections are more common and require rule-out.