In pelvic inflammatory disease, which finding corresponds to the chandelier sign?

• A. Mucopurulent discharge
• B. Cervical motion tenderness
• C. Abdominal tenderness
• D. Normal pelvic exam

Answer: (B)

Chandelier sign reflects cervical motion tenderness observed during a pelvic exam. In pelvic inflammatory disease, infection inflames the uterus, fallopian tubes, and surrounding peritoneum, so moving or palpating the cervix pulls on these irritated structures and provokes sharp, well-localized pain. The intense reaction—often with the patient crying out or drawing the knees up—gives the sign its name. This sign is most specific for PID among pelvic findings, whereas mucopurulent discharge can occur with cervicitis or PID but doesn’t demonstrate the painful response to cervix movement; abdominal tenderness and a normal pelvic exam do not capture this specific sign.