OC197: Transvaginal ultrasound findings in women with moderate to severe pelvic inflammatory disease

To investigate the transvaginal ultrasound findings in women diagnosed with moderate to severe pelvic inflammatory disease (PID) in a genitourinary medicine clinic (GUM). Prospective study. This study involved 31 consecutive women seen in a GUM clinic with a diagnosis of moderate to severe PID. All patients had a transvaginal scan (TVS) on the day of presentation. During the scan the presence of tubo-ovarian pathology was documented as well as ovarian mobility and site-specific pelvic tenderness (soft markers). All patients had ambulatory therapy and were reviewed in the GUM clinic after a course of antibiotics. The average age of the patients was 28 years (range 19–42 years) and all patients had had the pain for < 2 weeks. 3/31 (10%) had a pyosalpinx with pelvic tenderness. 1 patient has a tubo-ovarian abscess with pelvic tenderness. 10/31 (33%) patients had a normal scan, freely mobile ovaries with adnexal tenderness. 5/31 (16%) patients had a normal scan with tenderness and free fluid. 2/31 had a normal scan with free fluid. 7/32 (22.5%) patients had a normal scan with no abnormality or tenderness with freely mobile ovaries. Two patients had haemorrhagic ovarian cysts and 1 patient was diagnosed with cystitis. The transvaginal ultrasound findings in women with moderate to severe PID are varied. Indirect markers such as the presence of fluid, site-specific tenderness and ovarian mobility can indicated early disease prior to the formation of gross tubal pathology. 10% of patients will have other pathology as the cause of their pain.