Uterine Conditions (as cause of Abdominal Pain)

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.