Adnexal Tenderness: Causes & Reasons

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Possible Causes for Adnexal Tenderness

Female 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]

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

Symptoms and physical findings vary widely and may include lower abdominal tenderness, adnexal tenderness, and cervical motion tenderness. [bestpractice.bmj.com]

Tubo-Ovarian Abscess

Upon palpation, patients affected by a TOA usually report adnexal tenderness, that is unilateral. [symptoma.com]

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; [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]

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]

tenderness and pelvic masses), as well as microscopic evaluation of a cervicovaginal discharge sample. [news-medical.net]

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]

Adnexal tenderness Thickening or definite mass Minimum clinical criteria for diagnosis Cervical motion tenderness Uterine tenderness Adnexal tenderness The presence of temperature [medchrome.com]

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]

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; [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]

Oophoritis

Uterine, adnexal, or cervical motion tenderness, together with high fever and abdominal pain are hallmarks of PID and oophoritis. [symptoma.com]

Empirical antibiotic treatment is recommended for patients with otherwise unexplained uterine or adnexal tenderness and cervical motion tenderness, according to guidelines [emedicine.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]

Spontaneous Abortion

tenderness or peritoneal irritation can be consistent with an ectopic pregnancy Bimanual exam to determine the size of the uterus: Size of an orange: 6–8 wk Fundus at the [emergency.unboundmedicine.com]

tenderness on examination; and a white-cell count of more than 12×10 9 per liter — or the presence of one of the clinical features in addition to the clinician’s judgment [doi.org]

[…] amount of blood before having abnormal vital signs Pelvic exam: Determine whether the internal cervical os is open or closed Amount of bleeding Presence of POC Presence of adnexal [emergency.unboundmedicine.com]

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]

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]

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]

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]

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]

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]

Pyelonephritis

A pelvic exam with cervicitis, adnexal tenderness, and/or uterine tenderness provides definitive diagnosis. [emdocs.net]

Uterine Leiomyoma

Other differential diagnosis for this case could be a ruptured ectopic pregnancy, ruptured ovarian cyst or torsion of adnexal tumours. [npplweb.com]

Pelvic examination showed a 24 cm tender midline mass arising from the pelvis and attached to the uterus. No other adnexal masses were palpable. [archintsurg.org]

Acute abdominal pain, tenderness, signs of hemorrhage together with presence of uterine fibroid may be highly suggestive of hemorrhage from ruptured surface vessels of fibroid [npplweb.com]

Hypovolemic Shock

A tender adnexal mass suggests ectopic pregnancy. [merckmanuals.com]

Lymphogranuloma Venereum

Adnexal tenderness, and Cervical motion tenderness. [cdc.gov]

adnexal, and cervical motion tenderness) within 3 days after initiation of therapy. [cdc.gov]

and reduction in uterine, adnexal, and cervical motion tenderness) within 3 days after initiation of therapy. [cdc.gov]

Cystitis

Cystitis is a condition, characterized by inflammation of the bladder, which majorly occurs due to bacterial infection. It is a common form of lower urinary tract infection. The condition of cystitis presents itself with the following signs and symptoms: Dysuria Increase in urge to urinate Development of hematuria[…] [symptoma.com]

Colonic Diverticulosis

AIM: To determine the pattern and distribution of colonic diverticulosis in Thai adults. METHODS: A review of the computerized radiology database for double contrast barium enema (DCBE) in Thai adults was performed at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Incomplete studies[…] [ncbi.nlm.nih.gov]

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]

Adenocarcinoma of the Ovary

OBJECTIVE: The aim of this study was to assess the importance of appendectomy during surgery for mucinous ovarian cancer. It can be difficult to distinguish between primary ovarian and primary appendiceal cancers clinically, histologically, and immunohistochemically. Removal of the appendix may facilitate differential[…] [ncbi.nlm.nih.gov]

Salpingitis

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

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

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]

Pelvic Congestion Syndrome

Introduction Pelvic congestion syndrome (PCS) is widely considered to be a potential cause of chronic pelvic pain (CPP), prevalent in 10%–30% of patients presenting with the condition. 1 Congestion in the pelvis has long been associated with pelvic venous reflux, with females who demonstrate reflux in the ovarian or[…] [doi.org]

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]

Actinomycosis

Braz Dent J. 2017 Nov-Dec;28(6):688-693. doi: 10.1590/0103-6440201701449. Author information 1 Dentistry and Health Postgraduate Program, Dental School, UFBA - Universidade Federal da Bahia, Salvador, BA, Brazil. 2 Dental Practice, Private Clinic, Salvador, BA, Brazil. 3 Department of Pathology and Forensic Medicine,[…] [ncbi.nlm.nih.gov]