The costovertebral angle is the space between the last rib and the lumbar vertebrae above the kidneys. Sensitivity or tenderness in this area can indicate kidney problems, such as pyelonephritis or renal capsule inflammation. Costovertebral angle percussion is a common technique to evaluate kidney problems.
The costovertebral angle, sometimes referred to as the CVA, is the space created by the lateral downward slope of the last rib and the beginning of the lumbar vertebrae or posterior bones of the spine. The lumbar bones are the portion of the spinal bones between the diaphragm, a dome-shaped respiratory muscle that separates the trunk from the abdomen, and the sacrum or pelvis. This opening shapes or cuts out an area above the kidneys.
The area created by the costovertebral angle offers protection to the kidneys. However, feeling sensitivity or tenderness in this region can be a sign of some sort of problem with the kidneys or surrounding structures. Common kidney problems include pyelonephritis, a urinary tract infection that travels to the kidney causing abdominal pain, fever, painful urination, and pain radiating to the back in addition to tenderness from ACVA. Sudden onset of CVA sensitivity may suggest sudden swelling or distension of the renal capsule.
The renal capsule is a thick lining that surrounds the kidneys made up of several layers of tissue including adipose or fat tissue. Its role is to protect the kidneys from damage. When this envelope becomes inflamed, pain symptoms can also travel throughout the body and extend into the navel or navel area. The pain can be extreme as the swelling pushes on surrounding structures, including nerves. Nerve pressure is the main cause of pain radiating to a different area.
When changes in voiding, such as a change in urine color or a change in frequency, occur along with CVA tenderness, the kidneys are the main culprits. Additional urination problems may include nocturia or the need to urinate during the night and tenesmus, straining to urinate without results. A perinephric abscess or infection that causes a pocket of fluid known as pus around the kidneys and renal artery occlusion, a narrowing of the blood vessels that supply the kidneys, may also be the root cause of costovertebral angle tenderness .
The most common way to evaluate kidney problems is a technique called costovertebral angle percussion. This procedure is performed by placing one hand flat over the costovertebral angle and striking it with the side of the clenched fist of the opposite hand. The force of the blow should be light to moderate as hitting this area too hard can cause bruising or irritation to underlying structures, including the kidneys. If you feel pain, there is likely a kidney problem.
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