Costovertebral angle tenderness: Difference between revisions

Latest revision as of 05:17, 16 February 2025

Costovertebral Angle Tenderness[edit]

Diagram showing the location of the costovertebral angle.

Costovertebral angle tenderness (CVAT), also known as Murphy's punch sign or Pasternacki's sign, is a medical test in which pain is elicited by percussion of the area of the back overlying the kidneys. This test is used to assess for pyelonephritis or other kidney-related conditions.

Anatomy[edit]

The costovertebral angle is formed by the 12th rib and the vertebral column. It is located on the posterior side of the body, just lateral to the spine. The kidneys are retroperitoneal organs that lie in this region, making it a useful site for clinical examination.

Clinical Significance[edit]

Costovertebral angle tenderness is a classic sign of pyelonephritis, which is an infection of the kidney. It can also indicate other conditions such as renal calculi (kidney stones) or hydronephrosis. The presence of CVAT suggests inflammation or infection of the kidney.

Examination Technique[edit]

To assess for costovertebral angle tenderness, the examiner places one hand flat over the costovertebral angle and gently taps it with the other hand. A positive sign is indicated by the patient experiencing pain upon this percussion.

Differential Diagnosis[edit]

While CVAT is commonly associated with pyelonephritis, it is important to consider other potential causes of flank pain, such as:

Related pages[edit]

@@ Line 1: / Line 1: @@
-'''Costovertebral angle tenderness''' ('''CVAT''') is a medical term that refers to discomfort or pain that is felt when the [[Costovertebral angle]] (CVA) is palpated. The CVA is the angle formed by the vertebral column and the costal margin. This area is clinically significant as it is where the [[kidneys]] are located.
+{{DISPLAYTITLE:Costovertebral Angle Tenderness}}
-== Anatomy ==
+==Costovertebral Angle Tenderness==
+[[File:CVangle.png|thumb|right|Diagram showing the location of the costovertebral angle.]]
-The [[Costovertebral angle]] is located in the back of the body, just below the 12th rib. It is formed by the junction of the 12th rib and the vertebral column. The kidneys are located in this area, making it a significant point of reference in diagnosing kidney-related conditions.
+'''Costovertebral angle tenderness''' (CVAT), also known as '''Murphy's punch sign''' or '''Pasternacki's sign''', is a medical test in which pain is elicited by percussion of the area of the back overlying the [[kidneys]]. This test is used to assess for [[pyelonephritis]] or other kidney-related conditions.
-== Clinical Significance ==
+==Anatomy==
+The [[costovertebral angle]] is formed by the 12th rib and the vertebral column. It is located on the posterior side of the body, just lateral to the spine. The [[kidneys]] are retroperitoneal organs that lie in this region, making it a useful site for clinical examination.
-Costovertebral angle tenderness is a clinical sign that is often used in the diagnosis of kidney diseases. It is elicited by percussion of the area of the back overlying the kidney. The presence of pain or tenderness may indicate an infection or inflammation of the kidney, such as [[pyelonephritis]] or [[kidney stones]].
+==Clinical Significance==
+Costovertebral angle tenderness is a classic sign of [[pyelonephritis]], which is an infection of the [[kidney]]. It can also indicate other conditions such as [[renal calculi]] (kidney stones) or [[hydronephrosis]]. The presence of CVAT suggests inflammation or infection of the kidney.
-== Diagnosis ==
+==Examination Technique==
+To assess for costovertebral angle tenderness, the examiner places one hand flat over the costovertebral angle and gently taps it with the other hand. A positive sign is indicated by the patient experiencing pain upon this percussion.
-The diagnosis of CVAT is typically made through a physical examination. The healthcare provider will gently tap the area of the back where the kidneys are located. If the patient experiences pain or discomfort, this is considered a positive sign of CVAT. Further diagnostic tests, such as a [[urinalysis]] or [[imaging studies]], may be ordered to confirm the diagnosis and identify the underlying cause.
+==Differential Diagnosis==
+While CVAT is commonly associated with [[pyelonephritis]], it is important to consider other potential causes of flank pain, such as:
+* [[Renal calculi]]
+* [[Hydronephrosis]]
+* [[Polycystic kidney disease]]
+* [[Musculoskeletal pain]]
-== Treatment ==
+==Related pages==
+* [[Pyelonephritis]]
+* [[Kidney]]
+* [[Renal calculi]]
+* [[Hydronephrosis]]
-The treatment for CVAT depends on the underlying cause. If the cause is an infection, antibiotics may be prescribed. If the cause is kidney stones, treatment may include pain management, fluid therapy, and in some cases, surgical intervention.
+[[Category:Medical signs]]
-== See Also ==
-* [[Renal colic]]
-* [[Urinary tract infection]]
-* [[Kidney disease]]
-== References ==
-{{reflist}}
-[[Category:Medical terminology]]
-[[Category:Symptoms]]
-[[Category:Urology]]
 [[Category:Nephrology]]
-{{Medicine-stub}}