CVA tenderness sign

Indications

  • A patient presenting with upper right quadrant pain/tenderness
  • Concern for cholecystitis. Present of CVA tenderness indicate  urinary tract infection, especially UTIs that affect the upper urinary system such as the ureters and kidney.


Technique

  • The examiner first applies gentle pressure to the region at costo-verbral angle at 12 ribs any CVA tenderness often indicates kidney pathology.


Results

  • Positive:
    • The patient experiences pain/tenderness when you
      applying gentle tabbing on
  • Negative:
    • The patient is feels no significant pain/tenderness.

 

Diagnostic Accuracy

  • Sensitivity: 44% – 97%
  • Specificity: 48% – 96%
  • Likelihood ratios:
    • Positive test: 2.0
    • Negative test: nonsignificant
  • In older patients
    • Sensitivity: 48%
    • Specificity: 79%
    • Positive predictive value: 0.58