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CVA tenderness is also present in patients who have retrocecal appendicitis and retroperitoneal abscesses. [4] In patients with sickle cell disease, blockage of blood flow to the kidney may cause CVA tenderness. [4] A lack of CVA tenderness in patients with low back pain supports a diagnosis other than kidney pathology. [7]
Lloyd's sign indicates the presence of renal calculus or pyelonephritis when pain is elicited by deep percussion in the back between the 12th rib and the spine. [1] It is closely related to costovertebral angle tenderness, as the area of percussion is the same. However, Lloyd's sign is specifically defined as positive costovertebral angle ...
The costovertebral angle (Latin: arcus costovertebralis) is the acute angle formed on either side of the human back between the twelfth rib and the vertebral column. [ 1 ] The kidney lies directly below this area, so is the place where, with percussion ( Latin : sucussio renalis ), pain is elicited when the person has kidney inflammation .
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
Diagram showing the typical location of pain [8] Signs and symptoms of acute pyelonephritis generally develop rapidly over a few hours or a day. It can cause high fever, pain on passing urine , and abdominal pain that radiates along the flank towards the back.
The pain is typically severe, and narcotic therapy is often prescribed as a way to manage chronic pain. Sleep can be difficult because the supine position increases pressure on the flank. The onset of pain is often associated with nausea and vomiting, making pain management by oral opiates complicated. [2]
Renal colic, also known as ureteric colic, is a type of abdominal pain commonly caused by obstruction of ureter from dislodged kidney stones.The most frequent site of obstruction is the vesico-ureteric junction (VUJ), the narrowest point of the upper urinary tract.
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen.