Transverse section, showing the relations of the capsule of the kidney.

Murphy's punch sign or kidney punch or CVA Tendernessis elicited when gently tapping the area of the back overlying the kidney producing pain in people with an infection around the kidney (perinephric abscess) or pyelonephritis. Since the kidney lies directly below this area, known as the costovertebral angle, tapping disturbs the inflamed tissue causing pain. This is known as a positive murphy's sign. While no pain on tapping would constitute a negative Murphy's sign.

This medical test was first described by the American surgeon John Benjamin Murphy.^[1][2][3]

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