Table 3.

The most specific findings for the diagnosis of PID (Pelvic Inflammatory Disease)

The following findings are the most specific for arriving at a diagnosis of PID:
• Histopathology diagnosis of endometritis on endometrial aspirate tissue sample.
• Hydrosalpinx with or without free pelvic fluid on transvaginal sonogram or
• MRI showing TO (tubo-ovarian) mass, or
• Doppler studies suggestive of pelvic infection (e.g. tubal hyperaemia)
• Hysterosalpingography (HSG) is not recommended in acute infection, but if HSG is done then irregularity of the contour of the endometrial cavity and intravasation of contrast into the vascular and lymphatic system is sign of acute endometritis. • Acute Salpingitis is identified by a ragged contour of the lumen of the tubes and diverticular outpouchings on HSG. Pelvic tuberculosis leads to oedematous thickening of the walls of the tubes and dilatation. The tubes are dilated, convoluted and form a C or S shape. On HSG, tubercular salpingitis presents as hydrosalpinx, beaded tubes (lead pipe appearance).
• Hysteroscopy is not recommended in acute infection (endometritis/salpingitis) • In chronic endometritis, hysteroscopic features: endometrial micropolyposis, they are multiple 1-2 mm sized protrusions or polyps arising from the endometrium with associated endometrial stromal thickening and oedema
• Laparoscopically proven signs of PID