Fortin's test is a physical examination technique used to diagnose tenderness in the costovertebral angle, a region where the lower ribs meet the spine. This test is often used to assess for kidney infection, also known as pyelonephritis.
How is Fortin's Test Performed?
- Patient Positioning: The patient lies on their side with their back facing the examiner.
- Examiner's Action: The examiner places their hand over the patient's costovertebral angle, located at the junction of the 12th rib and the spine.
- Percussion: The examiner then gently taps on the hand with the other hand, creating a percussion sound.
- Pain Assessment: If the patient experiences pain or tenderness at the site of percussion, it is considered a positive Fortin's test.
Interpreting the Results
A positive Fortin's test suggests that the patient might be experiencing kidney inflammation, which can be caused by infection or other conditions. However, it is important to note that a positive Fortin's test is not a definitive diagnosis. Further investigations, such as urinalysis and imaging studies, are necessary to confirm the diagnosis.
Other Considerations
- False Positives: Other conditions, such as muscle strain or rib fracture, can also cause tenderness in the costovertebral angle, leading to a false positive Fortin's test.
- False Negatives: In some cases, patients with kidney infection might not experience pain or tenderness at the costovertebral angle, resulting in a false negative Fortin's test.
Summary
Fortin's test is a simple and quick physical examination technique that can be used to assess for tenderness in the costovertebral angle. While it is not a definitive diagnostic test, it can provide valuable information about the potential presence of kidney infection. Further investigations are necessary to confirm the diagnosis and determine the underlying cause of the pain.
