Suppose that Tina reported pain when you assessed for costovertebral angle (CVA) tenderness. Which of the following would be true?

A) CVA tenderness may indicate a kidney infection.
B) CVA tenderness may indicate liver enlargement.
C) CVA tenderness is an expected finding.
D) CVA tenderness is a rare finding.

If Tina reported pain with costovertebral angle (CVA) tenderness, it may indicate a kidney infection or urinary tract infection (UTI), such as pyelonephritis. The absence of additional symptoms doesn't rule out a kidney infection but could indicate a milder or early-stage infection. CVA tenderness doesn't typically suggest liver enlargement or is an expected finding in a standard physical examination.

Explanation:

If Tina reported pain when you assessed for costovertebral angle (CVA) tenderness, it's much likely that she might be having a kidney infection. CVA tenderness is often associated with urinary tract infections (UTI), particularly a condition known as pyelonephritis - an infection of kidneys. As per the Referred Pain Chart, kidneys project pain to the CVA and hence, CVA tenderness on examination would be a significant finding in kidney diseases or infections.

In conditions like pyelonephritis, along with CVA tenderness, patient may also present with additional symptoms such as fever, chills, nausea, vomiting, and frequent painful urination. If Tina is only reporting CVA tenderness without these additional symptoms, it doesn't necessarily rule out a kidney infection, but would usually indicate a milder or early-stage infection.

Note that CVA tenderness does not typically indicate liver enlargement or serve as an expected finding in a normal physical examination. Accordingly, in this scenario, statement A) 'CVA tenderness may indicate kidney infection' is the most likely to be true.

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