On physical examination, the other more frequent signs were cervical motion tenderness
In a teenage girl presenting with vaginal discharge, lower abdominal tenderness, adnexal tenderness, and cervical motion tenderness, the following differential diagnosis should be considered.
Susie's symptoms of cervical motion tenderness, adnexal tenderness, frequent urination, vaginal discharge, and temperature are compatible with this diagnosis.
of cases % Symptoms Pain abdomen 45 90 Amenorrhea 43 86 Bleeding PV 30 60 Vomiting/nausea 11 22 Fever 03 6 Fainting attacks 01 2 Signs Pallor 24 48 Hypotension and shock 08 16 Abdominal tenderness 43 86 Guarding 07 14 Distension 12 24 Cervical motion tenderness
40 80 Fornicial tenderness 36 72 Mass in the fornix 16 32 Table 3: Ultrasonographic findings (n=50) Ultrasonographic Findings No.
Cervical motion tenderness
, peritoneal signs, and adnexal masses are most specific for ectopic pregnancy, but are not sensitive?
74%) patients and the classical sign of cervical motion tenderness
was seen in 19(44.
Once competing diagnoses have been adequately excluded, an empiric trial of antibiotic therapy for acute pelvic inflammatory disease, coupled with close clinical follow-up, should be considered in patients with acute pelvic pain found to have cervical motion tenderness and bilateral adnexal tenderness on examination.
12) Cervical motion tenderness, the sine qua non of acute PID, is a sensitive sign of this disorder and can be elicited in up to 97% of cases (13); however, it lacks specificity as it can also be found in 43% of ectopic pregnancies (11) and 28% of patients with acute appendicitis.
Uterine size could not be assessed properly, no pelvic masses were felt, pouch of Douglas was full and there was marked cervical motion tenderness