Method Of Exam

An attempt should be made to palpate both the right and left kidneys.

The ballottement method is normally used.

• Keep your anterior hand steady in the deep palpation position in the right upper quadrant lateral and parallel to rectus muscle.
• Attempt to ballot the kidney with the other hand in costophrenic angle.
• An enlarged kidney should be palpable by the anterior hand.
• Repeat the same maneuver for the left kidney.

Alternate method for the right kidney:

• Place your left hand behind the patient between the rib cage and iliac crest and place your right hand below the right costal margin.
• While pressing your hands firmly together, ask the patient to take a deep breath. Attempt to feel the lower pole of the right kidney.
• Repeat the same maneuver for the left kidney.

Normal:  
In an adult, the kidneys are not usually palpable, except occasionally for the inferior pole of the right kidney. The left kidney is rarely palpable. An easily palpable or tender kidney is abnormal. However, the right kidney is frequently palpable in very thin patients and children.