Emergency Medical Technician (EMT) Intermediate Practice Exam

Pain to palpation of the costovertebral angle suggests which condition?

1. Pneumonia

2. Pyelonephritis

3. Appendicitis

4. Kidney stones

The correct answer is: Pyelonephritis

The indication of pain to palpation of the costovertebral angle is closely associated with pyelonephritis, which is an infection of the kidney. This anatomical region is where the lower ribs meet the spine, and tenderness upon palpation signifies potential kidney inflammation or infection. In the context of pyelonephritis, this finding helps differentiate the condition from other abdominal or thoracic issues. In contrast, while pneumonia may cause referred pain due to pleuritic irritation, it typically presents with respiratory symptoms rather than localized tenderness at the costovertebral angle. Appendicitis can present with abdominal pain, usually originating in the right lower quadrant, but it does not typically cause tenderness in the costovertebral angle area. Kidney stones might lead to renal colic and flank pain but generally do not elicit significant tenderness in the costovertebral angle area unless there is associated infection or obstruction. Understanding the relationship between the costovertebral angle and the kidneys aids in recognizing the clinical manifestations of renal pathologies, particularly in this context where pyelonephritis is clearly implicated.