Ultrasonographic evaluation of pelvic inflammatory disease

The relative frequencies of various sonographic patterns and features of pelvic inflammatory disease (PID) were examined in retrospective analyses of sonograms in 36 proven cases. The original sonographic reports correctly predicted PID in 34/36 patients (sensitivity = 94.4%). Two cases were found to be tubo-ovarian abscess although at first they were reported to be ovarian neoplasia. The most frequent finding was dilatation of the fallopian tube (72.2%). String sign within the dilated tube that would reflect increased interface within the endosalpinx was found in 50.0%, fluid collection in the Douglas' pouch in 47.2%, which was confirmed by the culdocentesis and aspiration in 16 cases, and/or tumor formation at the adnexal region in 38.9%. These findings were characteristic but not specific in PID. Careful sonographic scrutinization should improve the diagnostic accuracy of PID in patients with low abdominal pain, high temperature and low back pain.