<s>[INST] context: Clinical Triad for Diagnosis of PID Pelvic organ tenderness, Adnexal tenderness, Cervical motion tenderness (Suggests the presence of peritoneal inflammation, which causes pain when the peritoneum is stretched by moving the cervix and causing traction of the adnexa on the pelvic peritoneum) Direct or rebound abdominal tenderness may be present. Evaluation of both vaginal and endocervical secretions is a crucial pa of the workup of a patient with PID. Increased number of polymorphonuclear leukocytes may be detected in a wet mount of the vaginal secretions or in the mucopurulent discharge. More elaborate tests include Endometrial biopsy to confirm the presence of endometritis, Ultrasound or radiologic tests to characterize a tubo-ovarian abscess laparoscopy to confirm salpingitis visually A laparoscopy, if asked in the Questions, is indeed the best test to diagnose PID. Its not a practical option always since this is a common presentation in the OPD and will be impossible to do on every one . Regular OPD diagnosis is made by the clinical triad If a Laparoscopy is being done for some indication & the surgeon notices inflamed tubes, then it is diagnostic of a PID Also: Please note that for diagnosis of PID , any uterine procedure like hysteroscopy, HSG, sonosalpingography ,will all push in fluids through the Uterus and this can in fact increase the PID. [/INST] question: Endosalpingitis is best diagnosed by | options: A: laparoscopy B: X-Ray abdomen C: Hysterosalpingography D: Hystero-laparoscopy | answer: A </s>