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Infectious Diseases in Obstetrics and Gynecology
Volume 10, Issue 4, Pages 171-180
http://dx.doi.org/10.1155/S1064744902000194

Accuracy of Five Different Diagnostic Techniques in Mild-to-Moderate Pelvic Inflammatory Disease

1Obstetrics and Gynecology Department, Universidad Nacional de Colombia, Bogotá, Cambodia
2Clinical Epidemiology Centre, Universidad Nacional de Colombia, Instituto Materno Infantil, Carrera 10 # 1–66 sur., Bogotá, Cambodia
3Department of Pathology, Universidad Nacional de Colombia, Bogotá, Colombia
4National Institute of Health, Colombia

Received 4 March 2002; Accepted 3 September 2002

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis of PID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures.

Study design: A diagnostic performance test study was carried out by cross-sectional analysis in 61 women. A group presenting PID (n = 31) was compared with a group (n = 30) presenting another cause for non-specific lower abdominal pain (NSLAP). Diagnosis provided by an evaluated method was compared with a standard diagnosis (by surgical findings, histopathology, and microbiology). The pathologist was unaware of the visual findings and presumptive diagnoses given by other methods.

Results: All clinical and laboratory PID criteria showed low discrimination capacity. Adnexal tenderness showed the greatest sensitivity. Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100% specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83% sensitivity and 26% specificity.

Conclusions: Clinical criteria represent the best diagnostic method for discriminating PID. Laparoscopy showed the best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominal pain when caused by another factor. The other diagnostic methods might have limited use.