DYSMENORRHEA

Ask the following questions:

1. Are there abnormalities on pelvic examination? A tubo-ovarian mass on pelvic examination should suggest salpingo-oophoritis, endometriosis with a chocolate cyst, or ectopic pregnancy. Perhaps the uterus is abnormal, in which case one should suspect fibroids, endometrial carcinoma, uterine pregnancy, retroverted uterus, endometrial cast, or cervical polyp. A normal examination should suggest ovarian dysfunction, endocrine imbalance, and psychogenic causes.
2. What is the age of the patient? If the patient is young, she probably has a virginal uterus and may be considered to have primary dysmenorrhea. These cases are usually due to uterine hypoplasia, congenital malformations, ovarian dysfunction, or psychogenic causes.

DIAGNOSTIC WORKUP

Routine studies should include a CBC, sedimentation rate, chemistry panel, and thyroid profile. If there is vaginal discharge, a smear and culture should be done for gonorrhea and chlamydia. A cervical and rectal culture for these organisms may also be necessary. If there is a tubo-ovarian mass or enlarged uterus, abdominal ultrasound may help in differentiating the cause. A pregnancy test should be done. The pregnancy test of choice is radioimmunoassay for the beta subunit of human chorionic gonadotropin (HCG), which will be positive within a week of fertilization. If a ruptured ectopic pregnancy is expected, a peritoneal tap or culdocentesis may help if abdominal ultrasound is not conclusive. Laparoscopy may also be helpful in the diagnosis. A fern test and basal body temperature may help diagnose endometriosis. An exploratory laparotomy may be the only way to make a diagnosis in cases of a pelvic mass. If the pelvic examination is perfectly normal, sometimes a course of progesterone hormones is useful in alleviating the problem. A dilation and curettage may also be done to address the problem. Referral to a gynecologist is usually made before doing expensive diagnostic tests.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Pelvic inflammatory disease

Read excerpts from these other book chapters related to Pelvic inflammatory disease:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Pelvic inflammatory disease

• Back to symptom: Pelvic inflammatory disease: Introduction (review 22 causes)
• Next Book Extract About Pelvic inflammatory disease: VAGINAL DISCHARGE (Algorithmic Diagnosis of Symptoms and Signs)
• All Book Extracts: All Online Book Extracts for Pelvic inflammatory disease

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

 » Next page: VAGINAL DISCHARGE (Algorithmic Diagnosis of Symptoms and Signs)

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• VAGINAL DISCHARGE (Algorithmic Diagnosis of Symptoms and Signs)
• Dysmenorrhea (In a Page: Signs and Symptoms)
• Vaginal Discharge (In a Page: Signs and Symptoms)
• Vaginal Discharge (In A Page: Pediatric Signs and Symptoms)
• DYSMENORRHEA (Differential Diagnosis in Primary Care)

Tools & Services:

• Bookmark this page
• Related medical articles for Pelvic Inflammatory Disease:
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com