Gold standard for diagnosis for PID is:

Diagnostic Laproscopy REF: Novak's Gynecology 13th edition Chapter 15 Traditionally, the diagnosis of PID has been based on a triad of symptoms and signs, including pelvic pain, cervical motion and adnexal tenderness, and the presence of fever. More elaborate tests may be used in women with severe symptoms because an incorrect diagnosis may cause unnecessary morbidity. These tests include endometrial biopsy to confirm the presence of endometritis, ultrasound or radiologic tests to characterize a tuboovarian abscess (TOA), and laparoscopy to confirm salpingitis visually. Laparoscopy currently provides the most accurate way to diagnose salpingitis. It should be used when the diagnosis is unclear, paicularly in patients with severe peritonitis, to exclude a ruptured abscess or appendicitis.