When to use percussion over the costovertebral angle?
Costovertebral angle tenderness exam (CVA tenderness exam) assessment for possible kidney infection. During a head-to-toe nursing assessment in a patient who is suspected to have a kidney infection (pyelonephritis), it is important to perform percussion over the costovertebral angle for tenderness.
When to see a doctor about the costovertebral angle?
It’s best to see a doctor when you have tenderness or pain in this area. Use this interactive 3-D diagram to explore the location of the costovertebral angle: Pain or tenderness in this area can be caused by many things. The type of CVA pain and symptoms you have may indicate the cause of the pain. Here are some possible causes:
Where is the costovertebral angle on the CVA?
The angle that forms below the 12th rib and spine is the costovertebral angle. After finding the CVA, you will then place your non-dominate hand flat the angle (there are two angles you will perform percussion on, which are located over each kidney…right and left). Then form a fist with your dominate hand and firmly thump your non-dominate hand.
What are the treatment options for costovertebral joint disorders?
Initially, your physiotherapist can assist in diagnosing your problem and determine an appropriate treatment plan. Treatment may involve activity modification, using anti-inflammatory medications, electrotherapy treatment, costovertebral joint mobilisation or stretches.
How to test for kidney infection at the costovertebral angle?
Then form a fist with your dominate hand and firmly thump your non-dominate hand. Ask the patient if they felt any tenderness or pain. If pain or tenderness was felt at the costovertebral angle then the test is positive and the patient should be further evaluated for a kidney infection (pyelonephritis).