Method Of Exam
Author: A. Chandrasekhar, MD
Patient in sitting position.
Gently press the costovertebral angle.
Percuss the costovertebral angles.
Feel the paravertebral muscles to assess the tone.
Assess tenderness of ribs, paraspinal muscle and spine.
Auscultate the costovertebral angle for bruit.
Forceful blow will ellicit tenderness even in normal patients. Be gentle.
Tenderness of the ribs, vertebra or paraspinal muscles is usually not of renal origin.