Cervical motion tenderness (CMT)

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Cervical Motion Tenderness (CMT) refers to pain elicited during bimanual pelvic examination when the cervix is gently moved side-to-side.

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It is a highly sensitive but nonspecific sign indicating pelvic inflammation or infection, particularly of the upper genital tract.

Pain is transmitted via pelvic visceral afferent nerves due to peritoneal or adnexal irritation
Common in inflammatory or infectious conditions where movement of the uterus or cervix causes tension on inflamed tissues

Condition	Why CMT Occurs
‣	Infection of uterus, tubes, and/or ovaries; highly characteristic finding
‣	Tubal distension or rupture causes peritoneal irritation
‣	Inflammatory mass near cervix leads to pain on motion
‣	Adhesions tether reproductive organs, causing tenderness
Adnexal torsion	Stretching of utero-ovarian ligaments causes pain

Patient in dorsal lithotomy position
Use non-dominant hand on abdomen and two fingers of dominant hand in the vagina
Palpate cervix and gently move it laterally
Positive test: patient reports sharp pain during cervical movement

PID Diagnostic Triad (CDC Minimum Criteria):

Presence of any one should prompt empiric treatment for PID.