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What Is Costovertebral Tenderness?

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What Is Costovertebral Tenderness?
Costovertebral tenderness (CVA) is a medical test in which pain is elicited by percussion of the area of the back overlying the kidney. Indirect fist percussion causes the tissues to vibrate instead of producing a sound. To perform this test, place one hand over the 12th rib at the costovertebral angle on the back and thump that hand with the ulnar edge of the other fist. The person normally feels a thud but no pain. Sharp pain occurs with inflammation of the kidney or perinephric area. Because kidneys lies beneath this area and tapping disturbs the inflamed tissue causing pain. It is important to assess CVA tenderness in patients who presents with low back pain as it will help the provider to make an appropriate differential

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