Pelvic inflammatory disease (PID) is inflammation and infection of the upper genital tract in women, involving the fallopian tubes, ovaries and surrounding structures.
More than one milion women contract PID each year. Factors associated with PID are: young age, reduced socioeconomic circumstances, African or Afro-Caribbean ethnic origin, lower educational attainment, and recent new sexual partners. It is a polymicrobial infection caused by the ascent of organisms from the cervix; the most common organisms involved are Neisserya gonorrheae and Chlamydia trachomatis, and anaerobic bacteria also seem to be involved.
Diagnosis of PID can be difficult, because it can mimic several other pelvic diseases: ectopic pregnancy, ovarian cyst rupture, ovarian or adnexal torsion, endometriosis, neoplasms, urinary tract infection, and appendicitis.
Transvaginal sonography and MRI have been shown to be accurate in diagnosis.
US can demonstrate only ascitic fluid in the peritoneal cavity or, in the most severe cases, can shows adnexial masses with heterogeneous echopattern.
MRI findings are non specific; pelvic MRI can demonstrate an adnexal mass, ill defined, containing fluid with various signal intensity. Following administration of gadolinium the wall and the surrounding tissues enhance.
Laparoscopy, however, remains the gold standard.