Can the diagnosis of pelvic inflammatory disease be excluded without a bimanual examination

UMMS Affiliation

Department of Pediatrics; Department of Psychiatry; Senior Scholars Program

Publication Date


Document Type



Adolescent; Adult; Ambulatory Care Facilities; Chlamydia Infections; Emergency Service, Hospital; Female; Gonorrhea; Humans; Medical Records; Pelvic Inflammatory Disease; Retrospective Studies


Bacterial Infections and Mycoses | Female Urogenital Diseases and Pregnancy Complications | Pediatrics


Now that urine-based tests are available for detection of Chlamydia and gonorrhea, we sought to determine whether history alone could be used to exclude pelvic inflammatory disease (PID) and thus preclude a bimanual examination. The study design was a retrospective chart review. The study population included females aged 15-24 years diagnosed with PID. Outcome measures were documentation of screening symptoms (abdominal pain, dyspareunia, or abnormal vaginal bleeding) in the medical record. Our primary analysis was sensitivity of screening symptoms for identifying patients with PID. At least 1 of the 3 screening symptoms was reported by 93% of the PID group. If absence of all 3 screening symptoms were used as a screening instrument to exclude a bimanual examination, many women with lower genital tract symptoms could be evaluated noninvasively. However, this approach could result in delayed diagnosis of PID in a small number of patients. Before this strategy is adopted, a large prospective study is needed.


Clin Pediatr (Phila). 2004 Mar;43(2):153-8.

Journal/Book/Conference Title

Clinical pediatrics


Medical student Lloyd Fisher participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID