Adnexal-tenderness: Causes & Reasons

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Possible Causes for adnexal tenderness

Pelvic Inflammatory Disease

Seventeen days later, she presented with severe bilateral lower abdominal pain, cervical motion tenderness, uterine tenderness, and bilateral adnexal tenderness. [ncbi.nlm.nih.gov]

Uterine tenderness or cervical motion pain or adnexal tenderness is most often present on pelvic exam in most cases of moderate PID. [www2a.cdc.gov]

Chlamydia Infection

PID was defined by the presence of lower abdominal tenderness, adnexal tenderness and cervical motion tenderness in a patient with complaint of pelvic pain. [guttmacher.org]

and uterine or adnexal tenderness on examination. [cdc.gov]

or cervical motion tenderness with no other identifiable cause. 2 Culture techniques are the preferred method for detecting C. trachomatis infection, but they have been [web.archive.org]

Endometriosis

However, there may be: Posterior fornix or adnexal tenderness. [patient.info]

The physician should palpate for a fixed, retroverted uterus, adnexal and uterine tenderness, pelvic masses or nodularity along the uterosacral ligaments. [web.archive.org]

Palpable nodules in the posterior fornix or adnexal masses (endometriosis can cause cystic lesions on the ovaries, known as 'chocolate cysts'). [patient.info]

Gonorrhea

Adnexal tenderness (usually bilateral) or adnexal mass Intermenstrual bleeding Fever, chills, nausea, and vomiting (less common) In males, the major genitourinary symptoms [emedicine.medscape.com]

[…] abdominal pain: Most consistent symptom of PID Increased vaginal discharge or mucopurulent urethral discharge Dysuria: Usually without urgency or frequency Cervical motion tenderness [emedicine.medscape.com]

Tubo-Ovarian Abscess

All had lower abdominal tenderness and 9 (45%) had cervical motion or adnexal tenderness. [ncbi.nlm.nih.gov]

uterine tenderness, or adnexal tenderness. [emdocs.net]

On pelvic exam, you note purulent discharge from the cervix and severe bilateral adnexal tenderness to palpation. [saem.org]

Tubal Pregnancy

[…] of cervical motion tenderness (LR 4.9; 95% CI, 1.7-14; n 1435), an adnexal mass (LR 2.4; 95% CI, 1.6-3.7; n 1378), and adnexal tenderness (LR 1.9; 95% CI, 1.0-3.5; n 1435 [doi.org]

The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. [saem.org]

uterine tenderness, or adnexal tenderness. [emdocs.net]

Ectopic Pregnancy

[…] of cervical motion tenderness (LR 4.9; 95% CI, 1.7-14; n 1435), an adnexal mass (LR 2.4; 95% CI, 1.6-3.7; n 1378), and adnexal tenderness (LR 1.9; 95% CI, 1.0-3.5; n 1435 [ncbi.nlm.nih.gov]

A lack of adnexal abnormalities on transvaginal sonography (negative LR [LR ] 0.12; 95% CI, 0.03-0.55; n 6885) decreases the likelihood of ectopic pregnancy. [doi.org]

tenderness and masses state of cervix and material passing through it fetal heart (almost never heard in ectopic) INVESTIGATIONS beta-HCG (should almost double every 2 days [lifeinthefastlane.com]

Salpingitis

Findings of bilateral adnexal tenderness and signs of a lower genital tract infection (mucopus, or leukorrhea, or both) should prompt clinicians to consider the diagnosis [ncbi.nlm.nih.gov]

Cervicitis, adnexal tenderness and salpingitis were not associated with any specific serovar. [ncbi.nlm.nih.gov]

ESSENTIALS OF DIAGNOSIS Uterine, adnexal, or cervical motion tenderness. Abnormal discharge from the vagina or cervix. Absence of a competing diagnosis. [accessmedicine.mhmedical.com]

Metastatic Ovarian Carcinoma

A rare case of metastatic ovarian carcinoma arising from intrahepatic cholangiocarcinoma is reported and the literature reviewed. A 49-year-old woman presented with ascites and a left pelvic mass. Optimal debulking surgery was carried out including a segmental resection of segment 5/6 of the liver. Histopathology[…] [ncbi.nlm.nih.gov]

Ovarian Torsion

Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. [cdemcurriculum.com]

Pelvic inflammatory disease Sexually active female with lower abdominal pain, cervical motion tenderness, and adnexal tenderness. [online.epocrates.com]

There is adnexal tenderness. A raised white cell count is common. [radiopaedia.org]

Ovarian Cyst Torsion

Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. [cdemcurriculum.com]

One study of emergency department physicians found an inter-examiner reliability of only 23% for detection of pelvic masses, and only 32% for the presence of adnexal tenderness [emlyceum.com]

The abdomen may feel tender. Doctors usually suspect adnexal torsion based on symptoms and results of a physical examination. [merckmanuals.com]

Adenocarcinoma of the Ovary

BACKGROUND/AIMS: Patterns of metastasis and clinical behavior of mucinous ovarian cancers are poorly understood because of their rarity. METHODS: A retrospective review of records of women identified with pure mucinous invasive ovarian/tubal/peritoneal cancer during 1992-2012 at one institution. Survival[…] [ncbi.nlm.nih.gov]

Fallopian Tube Carcinoma

A urine pregnancy test should be performed in any woman of reproductive age with adnexal tenderness. [cancertherapyadvisor.com]

On the pelvic examination, she had cervical motion and adnexal tenderness. [e-crt.org]

Mucopurulent (green or yellow) discharge on speculum examination and acute cervical motion tenderness, uterine or adnexal tenderness are indicative for PID and TOA. [cancertherapyadvisor.com]

Chlamydial Pelvic Inflammatory Disease

The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. [cdemcurriculum.com]

tenderness, or both. [annals.org]

and adnexal tenderness, noted for 18); and the presence of all three symptoms (noted for 6). [nejm.org]

Chronic Pelvic Inflammatory Disease

The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. [saem.org]

Uterine Tenderness Adnexal Tenderness The following add support for the diagnosis: Fever ( 101 F / 38.3 C) Mucopurulent cervical discharge or friability Wet prep with abundant [pedemmorsels.com]

[…] or uterine tenderness or adnexal tenderness. [mshc.org.au]

Acute Pelvic Inflammatory Disease

An optimal set of PID indicators consisted of adnexal tenderness, lower abdominal pain of one week's duration and an elevated white blood cell count. [ncbi.nlm.nih.gov]

The most frequent signs and symptoms were abnormal vaginal discharge (100%), adnexal tenderness (97.1%), cervical motion tenderness (94.3%) and fever 38.3 degrees C (82.9% [ncbi.nlm.nih.gov]

tenderness, or both. [annals.org]

Pelvic Actinomycosis

A case of actinomycosis involving the pelvic cavity is reported. The patient had a pelvic mass clinically and radiographically. Barium enema examination showed a mass with extrinsic compression and fixed narrowing of the rectum with mucosal irregularity. A computed tomographic scan showed a pelvic mass displacing the[…] [ncbi.nlm.nih.gov]

Mucopurulent Cervicitis

All had a history of mild-to-moderate pelvic discomfort for 30 days or less, uterine or adnexal tenderness, and leukorrhea, mucopurulent cervicitis, or untreated gonococcal [acronymfinder.com]

uterine tenderness or adnexal tenderness. [clinicaltrials.gov]

adnexal tenderness, or cervical motion tenderness on pelvic exam. [stiplus.com.au]

Fitz-Hugh-Curtis Syndrome

The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. [cdemcurriculum.com]

During a pelvic exam, uterine or adnexal tenderness and cervical motion tenderness may be noted. Evidence of cervicitis may be present as well. [www2a.cdc.gov]

Pleuritic RUQ pain and tenderness may occur with or after the onset of acute PID. Some degree of cervicitis or adnexal tenderness is also usually present. [adhesions.org]

Adnexitis

[…] induced mucosal bleeding (signs of uterine or adnexal tenderness are an indication for treatment for pelvic inflammatory disease, see section on PID) OR the patient is from [glosbe.com]

Clinical manifestations Adnexitis: acute or slowly progressive lower abdominal pain, often bilateral; frequently begins after menses; fever; palpable tender mass. [ultrasound-cases.blogspot.com]

PID should be suspected in young, sexually active women who present with lower abdominal pain and adnexal/cervical motion tenderness! [amboss.com]

Vaginitis

Pelvic exam demonstrates an absence of cervical motion tenderness and no adnexal tenderness. Which of the following is the most likely diagnosis? [medbullets.com]

If there are symptoms, then fever, cervical motion tenderness, lower abdominal pain, new or different discharge, painful intercourse, uterine tenderness, adnexal tenderness [en.wikipedia.org]

Randomly selected STD clinic patients with BV were more likely than those without BV to have adnexal tenderness even after controlling for gonorrheal and chlamydial infections [glowm.com]

Abdominal Visceral Abscess

Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. [cdemcurriculum.com]

Associated with bilateral lower abdominal pain and cervical motion, uterine, or adnexal tenderness. [medical-institution.com]

Bimanual examination revealed no adnexal mass or tenderness, no cervical excitation. Larger amounts of pussy fluid exuded from the vagina. [ommegaonline.org]

Urinary Tract Infection

The abdomen should be examined especially for adnexal tenderness, which may suggest that the correct diagnosis is actually pelvic inflammatory disease. [microbiologybook.org]

Acute Cystitis

The abdomen should be examined especially for adnexal tenderness, which may suggest that the correct diagnosis is actually pelvic inflammatory disease. [microbiologybook.org]

Vaginal Candidiasis

OR uterine tenderness OR adnexal tenderness. [web.archive.org]

adnexal, and cervical motion tenderness) within 3 days after initiation of therapy. [web.archive.org]

Follow-Up Patients should demonstrate substantial clinical improvement (e.g., defervescence; reduction in direct or rebound abdominal tenderness; and reduction in uterine, [web.archive.org]

Ovarian Cyst

Physical examination reveals bilateral tender adnexal masses and diffuse peritoneal signs. [emedicine.medscape.com]

[…] or cervical motion tenderness Underlying malignancy may be associated with early satiety, weight loss/cachexia, lymphadenopathy, or shortness of breath related to ascites [emedicine.com]

Common findings include characteristic tender nodularity and tenderness of the obliterated cul-de-sac, parametrial thickening, and adnexal masses. [emedicine.medscape.com]

Sexually Transmitted Disease

Uterine or adnexal tenderness when pressing the outside and inside hands together. [patient.info]

OR uterine tenderness OR adnexal tenderness. [cdc.gov]

Cervical motion tenderness (often evident from facial expression) when the cervix is moved from side to side with the fingers of the gloved hand in the vagina. [patient.info]

Ruptured Ectopic Pregnancy

Right adnexal tenderness was noted on physical examination. [nejm.org]

(most frequent sign) adnexal tenderness or mass abdominal tenderness, rebounding, or guarding Cullen sign: blue discoloration around umbilicus suggesting retroperitoneal [sharinginhealth.com]

On examination, the patient may have localised abdominal tenderness, with vaginal examination revealing cervical excitation and/or adnexal tenderness. [teachmeobgyn.com]

Cervicitis

uterine tenderness or adnexal tenderness. [clinicaltrials.gov]

tenderness. [ww2.health.wa.gov.au]

Exclusion Criteria: Signs and symptoms of pelvic inflammatory disease, including cervical motion, uterine, or adnexal tenderness. [clinicaltrials.gov]

Pyosalpinx

and bilateral adnexal tenderness and at least one of the following minor diagnostic criteria were observed in sexually active women: documentation of a cervical infection [docksci.com]

Cervical motion tenderness or uterine or adnexal tenderness with lower abdominal or pelvic pain are the minimum diagnostic criteria. [lumen.luc.edu]

elevated ESR, paralytic iléus, and shock from peritonitis. 3 criteria should be present : * Lower abdominal tenderness * Adnexal tenderness * Tenderness with cervical motion [medicalechography.com]