In gynecology, cervical motion tenderness or cervical excitation (*chandelier sign), is a sign found on pelvic examination suggestive of pelvic pathology. Classically, it is present in the setting of pelvic inflammatory disease (PID), ectopic pregnancy, and is of some use to help differentiate PID from appendicitis.[1] It is also known by the colloquial name "chandelier sign" due to the pain being so excruciating upon bimanual pelvic exam (a part of a woman's physical examination where two hands are used to feel the anatomy of the pelvis) that it is as if the patient reaches up to motion the grabbing of a ceiling-mounted chandelier. The term "Chandelier's Sign" is utilized by various physicians to describe a reflexive reaction to variable stimuli which causes the patient to unexpectedly jump 'as if jumping to grab the proverbial chandelier'. ("Chandelier's Sign - The result of any test or probing after which the patient must be removed from the chandelier"[3] Word not found in the Dictionary and Encyclopedia.

Please try the words separately: Some articles that match your query: Chandeliers in the Savannah Chanderi Bunkar Vikas SamitiCervical motion tenderness, also known as the chandelier sign, is a physical exam finding that can suggest that certain gynecologic diseases are present. As the name implies, patients who have this physical exam finding experience significant pain upon manipulation of the cervix. Performing this test has diagnostic utility in differentiating abdominal pain caused by pathology of the reproductive tract from that caused by pathology of the gastrointestinal tract. Although cervical motion tenderness is most commonly associated with a condition called pelvic inflammatory disease, it can also be associated with ectopic pregnancies or ovarian cysts. To check for cervical motion tenderness, a pelvic exam is necessary, either using a speculum to localize the cervix, or using the examiner’s fingers to manipulate this structure. The cervix is an anatomic structure located between the uterus and the cavity of the vagina.

In some ways, it can be considered as the end part of the uterus that extends into the vagina. To fully view this structure, a speculum is inserted into the vagina. The cervix typically comes into view at the tip of the speculum, and appears as cylindrical structure with a small central opening. After visualizing the cervix with the use of a speculum, or after blindly feeling the cervix on physical exam, testing for cervical motion tenderness is easy. waterford ennis 6 arm chandelierIf moving the cervix causes significant pain, then the patient has cervical motion tenderness. chandelier ffxiThe usefulness of performing this test is that it can help localize the region of the body affected by disease. chandelier betydelseFor example, either appendicitis or an infection of the right ovary could cause pain in the lower right side of the abdomen.

Typically, an infection such as appendicitis would not be associated with this sign, whereas other disease processes could cause this pain. Most commonly, the finding of cervical motion tenderness is associated with pelvic inflammatory disease. Typically, this condition occurs when an infection of the vagina, such as a sexually transmitted disease, spreads and affects some of other female reproductive organs such as the ovaries, fallopian tubes, or the uterus. This disease can be dangerous if untreated, harming a woman’s future reproductive capabilities or in severe cases leading to death. In other cases, cervical motion tenderness can be associated with other pathologic conditions of the female reproductive tract. Women with an ectopic pregnancy, which occurs when a recently fertilized embryo attaches itself to the incorrect region of the female anatomy, can cause pain on movement of the cervix. Ovarian pathology, including cyst formation or the twisting of an ovary around the fallopian tube, can also cause this physical exam finding.

Prognosis, Prevention, and Complications A 20-year-old G0 female presents with 4 days of fever, pelvic pain, and left-sided adnexal tenderness. Physical examination reveals cervical motion tenderness and left adnexal fullness. Erythrocyte sedimentation rate (ESR) is elevated. Complete blood count values are as follows:White blood cell count: 17,000/mm^3Hemoglobin: 12 g/dLHematocrit: 36%Platelet count: 200,000/mm^3A CT scan of the pelvis is shown in Figure A. Which of the following is the most appropriate treatment for this patient's condition? Evidence & References Show Email to a Friend As a pediatric surgeon, I am often asked when to “worry” about abdominal pain. Children often report aches or pains near the belly button (umbilicus), and the question arises around when this might mean something significant such as appendicitis. Appendicitis is a common occurrence affecting about 7% of people over their lifetime, and it begins with vague abdominal pain of the central abdomen.

Once the appendix becomes obstructed and begins to suffer from lack of circulation (ischemia), the body can detect more accurately the exact source of the pain. After this localization occurs, children older than 6 or so can identify that the pain is most severe in the right lower part of the abdomen. The localization usually occurs within 24 hours of feeling unwell. The pain is typically worse with movement of the appendix during activities such as walking, coughing, and change in position. I often ask children to jump up and down (on their bed is something kids are excited to do!) and watch their face to see if they wince. Typically with appendicitis, a child will either refuse to jump or may try it once but will not continue due to the pain. Distraction is also frequently used in children that seem to be particularly “focused” on their pain. In gently feeling the abdomen of a child with early appendicitis that is distracted, the abdomen is soft until palpating the area of the appendix.

This right lower part of the abdomen is firm as the muscles in this area are contracting to protect the appendix (guarding). As the appendix is part of the intestinal tract, once it becomes swollen children typically lose their appetite, which can be the biggest clue to suggest appendicitis in a child that otherwise has a voracious appetite. A major goal of appendicitis management is to intervene before the appendix ruptures or perforates which is typically 24-48 hours from the onset of pain. In that regard, if a child has 12 hours or more of pain that is constant, localizes to the right lower abdomen, worsens with movement, and possibly associated with fever, loss of appetite, nausea/vomiting; then this would be concerning for appendicitis. But if pain is coming and going, less than 12 hours in duration, not localized, and your child is able to move easily without wincing or complaining of pain; this is most likely not appendicitis. Evaluation for appendicitis typically involves a thorough history, an examination of the abdomen, some lab tests, and possibly imaging if indicated.