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Pelvic infections

Radiology Department, Birmingham Women's Hospital, Edgbaston, Birmingham B15 2TG, UK

• Various terms are used to refer to the clinical condition of pelvic infection.
  
• Pelvic infections are mainly diagnosed clinically and with laboratory tests.
  
• Imaging is helpful in equivocal cases, for assessing complications and in offering alternative treatment options.
  
• Ultrasound is the first-line imaging modality.
  
• CT and MRI are useful in more complex situations or for further evaluation of adjacent structures.
  
• Hysterosalpingography plays no role in the acute situation.
  

Female genital tract infections are a significant cause of morbidity in women of reproductive age. The terms used vary, but pelvic inflammatory disease (PID) is the most commonly understood. The outcome is variable and can be severe in terms of fertility problems, chronic pelvic pain and an increased incidence of ectopic pregnancy, which may be life threatening. The wide variation in presentation means that clinical assessment alone may be difficult, although most cases can be diagnosed on clinical grounds. The main role of imaging is in the exclusion of other causes of the symptoms and also in equivocal cases. Imaging examinations may also be used as an aid to achieving a diagnosis or in treatment, e.g. in guiding drainage procedures. This article reviews the role of various imaging modalities in the assessment of patients with PID.