A positive result from the kidney punch test might indicate the possibility of kidney disease. The patient will have to undergo further tests to confirm if they do have a disease and what could be causing the pain.
The Kidney punch test involves striking the costovertebral angle. The costovertebral angle is the acute angle located at the bottom of the ribcage and the spine. To locate the costovertebral angle, count to the 12th rib of the patient’s ribcage and locate the center where the spine and the rib meet.
When this angle is hit by blunt force, a patient with some form of kidney disease will feel pain. The pain is due to the inflammation of the kidney. Since the kidney is directly anterior to the costovertebral angle, disturbance in the inflamed tissues elicits pain.
Steps in conducting a Kidney Punch Test
- The examiner will assist the patient into a sitting position and make sure that they are sitting as comfortably as possible.
- The examiner should position themselves at the patient’s back.
- The goal is to find the costovertebral angle by locating the 12th rib. Below the 12th rib is an acute angle between the spine. This angle is the costovertebral angle.
- Then, the examiner will lay the non-dominant hand flat on this area.
- The examiner will then make a fist with their dominant hand.
- Using the dominant hand, the examiner will gently but firmly punch or thump the back of their non-dominant hand.
- Then the examiner will ask patient if they felt any discomfort or pain.
Note: A forceful blow will cause pain even in normal patients. The examiner must be gentle in applying force to the costovertebral angle.
If the patient reports pain during the kidney punch test, they have tested positive for the test and this might indicate that there is inflammation in the kidneys.