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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.
Blumberg's sign (also referred to as rebound tenderness or Shchetkin–Blumberg's sign) is a clinical sign in which there is pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.) It is indicative of peritonitis.
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