Pelvic Inflammatory Disease

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The aim of testing is to diagnose pelvic inflammatory disease, to discover the microorganism(s) causing it, if possible, and to distinguish PID from other conditions with similar symptoms. There is not one single laboratory test that can definitely diagnose PID. Most cases are diagnosed based on clinical findings. Some are diagnosed when a person is screened for STDs as part of a physical examination. PID may go unrecognized and undiagnosed as frequently as two-thirds of the time because the symptoms are nonspecific. There are several tests that may be performed to help diagnose the condition.

Laboratory Tests
Some tests that may be requested to determine the cause of PID or rule out other causes of pelvic pain include:

  • Chlamydia trachomatis test – to detect chlamydia infection as cause of PID
  • Neisseria gonorrhoeae test – to detect gonorrhea infection as cause of PID
  •  Wet prep – a sample of vaginal/cervical discharge is placed on a slide and examined under a microscope. It is primarily performed to count the number of white blood cells (WBCs) in the discharge; often elevated with PID
  • Cervical culture – requested to help identify causative microorganisms
  • Urine culture – performed to detect a urinary tract infection
  • Tests that are not specific for PID but may be used to detect and evaluate the inflammation and immune response associated with it include:

  • FBC (Full Blood Count) – performed to evaluate white and red blood cell counts
  • ESR (Erythrocyte Sedimentation Rate) – nonspecific indicator of inflammation
  • CRP (C-Reactive Protein) – nonspecific indicator of inflammation
  • A pregnancy test may be performed to determine whether a woman is pregnant and to help identify ectopic pregnancy.

    Non-Laboratory Tests

    • Physical examination – an evaluation of the cervix, discharge, and degree of pain or tenderness present. Cervical motion pain and uterine pain are characteristic of PID. A diagnosis may be made based upon clinical findings.
    • Pelvic or transvaginal ultrasound – may be performed to examine reproductive organs
    • Laparoscopy – minimally invasive surgery sometimes used to confirm the diagnosis, collect biopsy samples, and evaluate organ status
    • CT (computed tomography) scan or MRI (magnetic resonance imaging) scan
    • Power Doppler ultrasound – scan that allows evaluation of blood flow and inflammation

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