[lee-usmle]

One of the classic case scenarios seen in USMLE is the description of the a premenopausal female with h/o multiple sexual partners, vaginal discharge, fever, and suprisingly an right upper abdominal pain.
This is a classic presentation of Fitz Hugh Curtis Syndrome in which the infection ascends from a PID (typically salpingitis) to involve the capsule of the liver and therefore pain may sometimes refer to the right scapula and tip of shoulder.

 

[karthiksamineni]

And also

And also...upper right-quadrant abdominal pain and tenderness aggravated by breathing, coughing or movement, and referred to the right shoulder following an episode of PID. Laparoscopy may reveal "violin string" adhesions.

 

[usmledream9]

Thank You

Thank You

 

[usmle016]

Thank you :indifferent:

 

[Mollie Grant]

Thanks for your post