Costovertebral angle pain is a classic clue for which condition?

Costovertebral angle (CVA) pain is a classic sign associated with renal pathology, particularly pyelonephritis. This condition involves inflammation of the kidney, often due to a urinary tract infection that ascends to involve the renal tissue. When there is inflammation or irritation in the renal area, it can stimulate the nociceptors that are present near the CVA, resulting in pain that is typically felt when the area is tapped or palpated.

In cases of pyelonephritis, the pain is usually localized to the flank or lower back, and the presence of CVA tenderness upon examination is a significant indicator of this infection. This symptom can also be accompanied by other signs such as fever, dysuria, and increased urinary frequency, which further supports the diagnosis.

In contrast, while conditions like appendicitis, cholecystitis, and renal stones may present with abdominal or flank pain, they do not specifically cause CVA tenderness to the same degree as pyelonephritis. Appendicitis typically presents with right lower quadrant pain, cholecystitis with right upper quadrant pain, and renal stones may present with colicky pain that radiates. However, the hallmark of CVA tenderness firmly links py