Image of the Week: Do you recognize the clinical triad in this emergency case?

A 35-year-old woman presents to the emergency department with lower abdominal pain and vaginal spotting. Her last menstrual period was nine weeks ago. She was treated for a chlamydial cervical infection in the past and has never taken oral contraceptives. On abdominal examination, no mass is detected, however, there is moderate tenderness in the right adnexal region. Laboratory studies reveal ...