How to check for pelvic inflammatory disease and how to diagnose pelvic inflammatory disease

Pelvic inflammatory disease is a common gynecological disease that can occur at one time or in several places at the same time. The more common ones are acute pelvic inflammatory disease and chronic pelvic inflammatory disease. As for how to detect pelvic inflammatory disease, it can usually be detected through some obvious symptoms or through some disease examinations.

1. Minimum Standards

Cervical motion tenderness or uterine tenderness or adnexal tenderness.

2. Additional Standards

Body temperature exceeds 38.3℃; abnormal mucopurulent secretions from the cervix or vagina; a large number of white blood cells are seen in the image of 0.9% NaCl solution in vaginal secretions; increased erythrocyte sedimentation rate; increased blood C-reactive protein; laboratory-confirmed cervical gonorrhea or Chlamydia trachomatis positive.

3. Specific standards

For patients with a history of acute pelvic inflammatory disease and symptoms and signs, diagnosis is usually not difficult. However, sometimes patients have many symptoms but no obvious history of pelvic inflammatory disease or positive signs. At this time, the diagnosis of chronic pelvic inflammatory disease must be made with caution to avoid making a hasty diagnosis and causing mental burden to the patient. Sometimes pelvic congestion or varicose veins within the broad ligament can also produce symptoms similar to chronic inflammation. Chronic pelvic inflammatory disease and endometriosis are sometimes difficult to distinguish. Endometriosis causes more obvious dysmenorrhea, and the feeling of typical nodules will help with diagnosis. Laparoscopy can be performed when differentiation is difficult. Hydrosalpinx or tubo-ovarian cysts need to be differentiated from ovarian cysts. In addition to a history of pelvic inflammatory disease, the former has a sausage-shaped lump with a thin cyst wall and adhesions around it; while ovarian cysts are generally more round or oval in shape, have no adhesions around them, and move freely. Pelvic inflammatory adnexal masses are adhered to the surrounding area and are immobile, which can sometimes be confused with ovarian cancer. Inflammatory masses are cystic while ovarian cancer is solid. B-mode ultrasound examination can help to differentiate them.

4. Others

Acute and chronic pelvic inflammatory disease can be diagnosed based on medical history, symptoms, and signs. However, differential diagnosis must be done well. The main differential diagnoses of acute pelvic inflammatory disease include acute appendicitis, ectopic pregnancy, ovarian cyst pedicle torsion, etc.; the main differential diagnoses of chronic pelvic inflammatory disease include endometriosis and ovarian cancer.