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Clinical examination of the kidneys

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On physical examination, a kidney is characterised by:

  • a palpable upper border; one can feel space between the kidney and the costal margin
  • it moves inferiorly on inspiration
  • it is ballotable
  • the percussion note is usually resonant, because of overlying loops of gas-filled bowel

Recognising an enlarged left kidney from an enlarged spleen, in addition to the above, is aided by:

  • a kidney does not have a notch
  • a kidney never has a friction rub

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