Method Of Exam

• Patient in sitting position
• Gently press the costo-vertebral 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.

Caution:

Forceful blow will ellicit tenderness even in normal patients. Be gentle.
Tenderness of the ribs, vertebra or paraspinal muscles is usualyy not of renal origin.