Physicians use several methods to diagnose pelvic inflammatory disease (PID). A thorough medical history, including a history of sexual partners, begins the process. Physicians then perform a pelvic examination, which includes swabs of the vaginal and cervical areas. Blood and urine tests may also be performed for infections (including sexually transmitted diseases) and pregnancy. However, PID may not produce enough white blood cells characteristic of an infection to be detected with the blood tests.

A pelvic ultrasound is sometimes used to determine the areas that may be affected by PID. This procedure creates a video image using sound waves. During an ultrasound, a small probe is placed on a patient’s abdomen or inside the vagina (transvaginal ultrasound). The probe releases sound waves, which echo as they enter the body’s organs. Ultrasound can be useful in identifying an abscess or enlarged areas, which reflect sound waves differently.

For women with severe symptoms, a physician may conduct a laparoscopic examination. During this procedure, the physician inserts a slender, lighted tube through an incision in the patient’s abdomen and examines the pelvic organs. This procedure provides a view of the patient’s organs that can help the physician diagnose and plan treatments. Additionally, laparoscopy allows physicians to manipulate small instruments through the patient’s incision to perform a biopsy, obtaining tissue for microscopic examination.

These diagnostic methods may rule out other conditions, or, combined with the patient’s symptoms, may indicate PID. Laparoscopy usually confirms the diagnosis but physicians may diagnose PID and begin treatment even without a laparoscopy.