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Costovertebral angle tenderness

MedGen UID:
1053384
•Concept ID:
CN376616
•
Finding
Synonym: Costovertebral angle pain
 
HPO: HP:6000106

Definition

Pain that is elicited by palpation of the region inside of the costovertebral angle, which is formed by the 12th rib and the spine. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVCostovertebral angle tenderness

Professional guidelines

PubMed

Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Acute pyelonephritis: clinical characteristics and the role of the surgical treatment.
Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG
J Korean Med Sci 2009 Apr;24(2):296-301. Epub 2009 Apr 20 doi: 10.3346/jkms.2009.24.2.296. PMID: 19399273Free PMC Article
Contemporary management of uncomplicated urinary tract infections.
Guay DR
Drugs 2008;68(9):1169-205. doi: 10.2165/00003495-200868090-00002. PMID: 18547131

Recent clinical studies

Etiology

High risk and low prevalence diseases: Infected urolithiasis.
Yoo MJ, Pelletier J, Koyfman A, Long B
Am J Emerg Med 2024 Jan;75:137-142. Epub 2023 Nov 3 doi: 10.1016/j.ajem.2023.10.049. PMID: 37950981
Skin-to-Renal Pelvis Distance Predicts Costovertebral Angle Tenderness in Adult Patients with Acute Focal Bacterial Nephritis.
Kaneko M, Ishimaru N, Shimokawa T, Nakajima T, Kanzawa Y, Seto H, Kinami S
South Med J 2023 Jan;116(1):20-25. doi: 10.14423/SMJ.0000000000001493. PMID: 36578113
Urinary Tract Infection in Children.
Leung AKC, Wong AHC, Leung AAM, Hon KL
Recent Pat Inflamm Allergy Drug Discov 2019;13(1):2-18. doi: 10.2174/1872213X13666181228154940. PMID: 30592257Free PMC Article
Pyelonephritis can lead to life-threatening complications.
Keenan DB, O'Rourke DM, Courtney AE
Practitioner 2017 Feb;261(1801):17-20. PMID: 29020720
Contemporary management of uncomplicated urinary tract infections.
Guay DR
Drugs 2008;68(9):1169-205. doi: 10.2165/00003495-200868090-00002. PMID: 18547131

Diagnosis

High risk and low prevalence diseases: Infected urolithiasis.
Yoo MJ, Pelletier J, Koyfman A, Long B
Am J Emerg Med 2024 Jan;75:137-142. Epub 2023 Nov 3 doi: 10.1016/j.ajem.2023.10.049. PMID: 37950981
Skin-to-Renal Pelvis Distance Predicts Costovertebral Angle Tenderness in Adult Patients with Acute Focal Bacterial Nephritis.
Kaneko M, Ishimaru N, Shimokawa T, Nakajima T, Kanzawa Y, Seto H, Kinami S
South Med J 2023 Jan;116(1):20-25. doi: 10.14423/SMJ.0000000000001493. PMID: 36578113
Urinary Tract Infection in Children.
Leung AKC, Wong AHC, Leung AAM, Hon KL
Recent Pat Inflamm Allergy Drug Discov 2019;13(1):2-18. doi: 10.2174/1872213X13666181228154940. PMID: 30592257Free PMC Article
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Does this woman have an acute uncomplicated urinary tract infection?
Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S
JAMA 2002 May 22-29;287(20):2701-10. doi: 10.1001/jama.287.20.2701. PMID: 12020306

Therapy

Urinary Tract Infection in Children.
Leung AKC, Wong AHC, Leung AAM, Hon KL
Recent Pat Inflamm Allergy Drug Discov 2019;13(1):2-18. doi: 10.2174/1872213X13666181228154940. PMID: 30592257Free PMC Article
Pyelonephritis can lead to life-threatening complications.
Keenan DB, O'Rourke DM, Courtney AE
Practitioner 2017 Feb;261(1801):17-20. PMID: 29020720
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935
Contemporary management of uncomplicated urinary tract infections.
Guay DR
Drugs 2008;68(9):1169-205. doi: 10.2165/00003495-200868090-00002. PMID: 18547131
Prevention of ureteral injuries in gynecologic surgery.
Chan JK, Morrow J, Manetta A
Am J Obstet Gynecol 2003 May;188(5):1273-7. doi: 10.1067/mob.2003.269. PMID: 12748497

Prognosis

Skin-to-Renal Pelvis Distance Predicts Costovertebral Angle Tenderness in Adult Patients with Acute Focal Bacterial Nephritis.
Kaneko M, Ishimaru N, Shimokawa T, Nakajima T, Kanzawa Y, Seto H, Kinami S
South Med J 2023 Jan;116(1):20-25. doi: 10.14423/SMJ.0000000000001493. PMID: 36578113
Clinical findings predictive of maternal adverse outcomes with pyelonephritis.
Stephens AJ, Baker A, Barton JR, Chauhan SP, Sibai BM
Am J Obstet Gynecol MFM 2022 Mar;4(2):100558. Epub 2021 Dec 31 doi: 10.1016/j.ajogmf.2021.100558. PMID: 34979304
Determinants of pyelonephritis onset in patients with obstructive urolithiasis.
Abi Tayeh G, Safa A, Sarkis J, Alkassis M, Khalil N, Nemr E, El Helou E
Urologia 2022 Feb;89(1):100-103. Epub 2021 Aug 2 doi: 10.1177/03915603211035244. PMID: 34338097
Pyelonephritis can lead to life-threatening complications.
Keenan DB, O'Rourke DM, Courtney AE
Practitioner 2017 Feb;261(1801):17-20. PMID: 29020720
Diagnosis, Treatment, and Prevention of Urinary Tract Infection.
Pietrucha-Dilanchian P, Hooton TM
Microbiol Spectr 2016 Dec;4(6) doi: 10.1128/microbiolspec.UTI-0021-2015. PMID: 28087935

Clinical prediction guides

Comprehensive prediction of urolithiasis based on clinical factors, blood chemistry and urinalysis: UROLITHIASIS score.
Kim HJ, Oh SH
Sci Rep 2023 Sep 9;13(1):14885. doi: 10.1038/s41598-023-42208-9. PMID: 37689768Free PMC Article
Skin-to-Renal Pelvis Distance Predicts Costovertebral Angle Tenderness in Adult Patients with Acute Focal Bacterial Nephritis.
Kaneko M, Ishimaru N, Shimokawa T, Nakajima T, Kanzawa Y, Seto H, Kinami S
South Med J 2023 Jan;116(1):20-25. doi: 10.14423/SMJ.0000000000001493. PMID: 36578113
Clinical findings predictive of maternal adverse outcomes with pyelonephritis.
Stephens AJ, Baker A, Barton JR, Chauhan SP, Sibai BM
Am J Obstet Gynecol MFM 2022 Mar;4(2):100558. Epub 2021 Dec 31 doi: 10.1016/j.ajogmf.2021.100558. PMID: 34979304
Determinants of pyelonephritis onset in patients with obstructive urolithiasis.
Abi Tayeh G, Safa A, Sarkis J, Alkassis M, Khalil N, Nemr E, El Helou E
Urologia 2022 Feb;89(1):100-103. Epub 2021 Aug 2 doi: 10.1177/03915603211035244. PMID: 34338097
Urinary Tract Infection in Children.
Leung AKC, Wong AHC, Leung AAM, Hon KL
Recent Pat Inflamm Allergy Drug Discov 2019;13(1):2-18. doi: 10.2174/1872213X13666181228154940. PMID: 30592257Free PMC Article

Recent systematic reviews

Screening for Referral of Serious Pathology by Physical Examination Tests in Patients with Back or Chest Pain: A Systematic Review.
Andreoletti F, Maselli F, Storari L, Vongher A, Erbesato M, Testa M, Turolla A
Int J Environ Res Public Health 2022 Dec 7;19(24) doi: 10.3390/ijerph192416418. PMID: 36554298Free PMC Article

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