Cervical motion tenderness

Cervical examination is performed during: assessment of the ladies’s urogenital system. During an internal visual examination, you possibly can assess its color and site, in addition to possible pathological changes and discharge, and take samples from the cervix.

Assessment of cervical motion tenderness (CMT) is an element of the bimanual examination. To evaluate CMT, insert your index and middle fingers into the vagina until they’re within the posterior vaginal fornix. Then, along with your other hand, press the abdominal wall, within the suprapubic area. Each hand applies pressure to the alternative hand, allowing you to completely examine the scale, position, shape and mobility of your cervix and assess whether there may be tenderness or palpable changes. On bimanual examination, proceed to evaluate the uterus and ovaries to tell apart the situation of acute tenderness or to find out whether isolated CMT is present.

CMT is a crucial clinical symptom that usually indicates peritoneal irritation. CMT, uterine and/or adnexal tenderness define the features of acute symptomatic pelvic inflammatory disease (PID) (Ross and Chacko, 2022). CMT can be an indicator symptom of ectopic pregnancy and appendicitis (Bickley et al., 2021), but may assist in the differential diagnosis of any process involving the peritoneum, similar to diverticulitis, inflammatory bowel disease, hernia, perforation of an abdominal organ, wall abdominal hematoma, ureterolithiasis, interstitial cystitis, endometriosis, endometritis, tubal-ovarian abscess, ovarian or adnexal torsion, chronic pelvic cellulitis, vaginitis, cervicitis or pelvic thrombophlebitis (Cortes and Adamski, 2021).

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and interviewing (thirteenth ed.). Wolters Kluwer Health: Philadelphia.

Cortes, E. G., Adamski, J. J. The Chandelier Sign. [Updated 2021 Jul 15]. In: StatPearls [Internet]. Treasure Island (Florida): StatPearls Publishing; 2022 January-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545286/

Ross, J., & Chacko, M. (2022, April 20). Pelvic inflammatory disease: clinical symptoms and diagnosis. https://www.uptodate.com/contents/pelvic-itis-disease-clinical-manifestations-and-diagnosis