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Costovertebral angle tenderness

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Title: Costovertebral angle tenderness  
Author: World Heritage Encyclopedia
Language: English
Subject: Costovertebral, Abdominal pain, Nephrology, Extravasation of urine, Post-void dribbling
Collection: Abdominal Pain, Nephrology
Publisher: World Heritage Encyclopedia

Costovertebral angle tenderness

The costovertebral angle is located in the back between the 12th rib and the spine
Image of a human back

Costovertebral angle tenderness (CVAT), also known as Murphy's punch sign or the Pasternacki's Sign (Latin: succusio renalis), is a medical test in which pain is elicited by percussion of the area of the back overlying the kidney (the costovertebral angle, an angle made by the vertebral column and the costal margin). The test is positive in people with an infection around the kidney (perinephric abscess), pyelonephritis, hemorrhagic fever with renal syndrome or renal stone. Because the kidney lies directly below this area, known as the costovertebral angle, tapping disturbs the inflamed tissue, causing pain.

This medical test was first described by the American surgeon John Benjamin Murphy in 1884, but in Eastern Europe and former Soviet Influenced Regions, it is often called Pasternacki's Sign after the Belorussian Internist, Fiodor Ignatjevich Pasternacki (1845–1902) who described it during his rounds in a Regional Hospital in Minsk in 1888.[1][2][3][4]


  1. ^ Oh, Timothy T.; Schmitz, Robert L. (1993). The Remarkable surgical practice of John Benjamin Murphy. Urbana: University of Illinois Press.  
  2. ^ Musana KA, Yale SH (August 2005). "Murphy's Sign". Clin Med Res 3 (3): 132.  
  3. ^ Musana K, Yale SH (May 2005). "John Benjamin Murphy (1857 - 1916)". Clin Med Res 3 (2): 110–2.  
  4. ^

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