Assessment and Causes of Renal Enlargement


  1. Hydronephrosis – accumulation of urine in the kidney due to obstruction in the ureter.
  2. Neoplasm
  3. Polycystic kidney disease – inherited disease causing growth of multiple large cysts within the kidneys resulting in end-stage renal disease.


  • Kidney tenderness is usually looked at posteriorly during examination of the back, saving the patient needless exertion
  • Place palm of your left hand over each costovertebral angle in turn
  • Strike it with the ulnar surface of your right fist
  • Normally the patient should perceive a jar or thud, but no pain.

Bates, Barbara. 1974. A Guide to Physical Examination. J.B. Lippincott Company, Toronto.


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