Imaging pelvic inflammatory disease

Abstract

Pelvic inflammatory disease (PID) encompasses a range of infections of the female genital tract that may be asymptomatic, or range from mild non-specific symptoms to fulminant life-threatening disease. Infection can involve the endometrium, fallopian tubes or ovaries and can occasionally spread to involve the peritoneum. Mostly PID is diagnosed clinically and treated without the need for imaging. Where imaging is required, it is mainly for the assessment of non-specific clinical symptoms and signs in which PID is a differential diagnosis, or for the complications of more severe PID infections. The high resolution of ultrasound makes it highly sensitive for the evaluation of the gynaecological organs including the fallopian tubes when abnormal, and is usually the first imaging investigation obtained. Other types of imaging including computed tomography, magnetic resonance imaging and hysterosalpingography are also used, mainly in more complex cases. The imaging appearances of PID on all modalities are discussed in this review to obtain an overall picture of imaging this disease.