Case report

Critical Ultrasound Journal

, 4:20

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Sonographic cervical motion tenderness: A sign found in a patient with pelvic inflammatory disease

  • Resa E LewissAffiliated withDepartment of Emergency Medicine, St. Luke’s/Roosevelt Hospital Center
  • , Turandot SaulAffiliated withDepartment of Emergency Medicine, St. Luke’s/Roosevelt Hospital Center Email author 
  • , Katja GoldflamAffiliated withDepartment of Emergency Medicine, Yale-New Haven Hospital


No single historical, physical, laboratory, or imaging finding is both sensitive and specific for the diagnosis of pelvic inflammatory disease (PID). Cervical motion tenderness (CMT), when present, is classically found on bimanual examination of the cervix and uterus. CMT is often associated with PID but can be present in other disease entities. We present a case report of a patient who was ultimately diagnosed with acute PID. The evaluating physician performed a trans-vaginal bedside ultrasound, and the operator appreciated ‘sonographic CMT’. In cases where the physical examination is equivocal or in patients where the exact location of tenderness is difficult to discern, performing a trans-vaginal bedside ultrasound examination can increase the physician's confidence that CMT is present as the cervix is being directly visualized as pressure is applied with the probe. Bedside ultrasound and specifically sonographic CMT may prove useful in diagnosing PID in patients with equivocal or unclear physical examination findings.


Pelvic inflammatory disease PID Cervical motion tenderness Sonographic CMT Bedside ultrasound