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| Definition: |
Point tenderness is a symptom in which pain is noted when pressure is applied over a specific point on the abdomen.
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| Considerations: |
The abdomen is an area of the body easily examined by touch (palpation). Without bony shielding, such as the rib cage around the chest, masses and organs within the abdomen can be felt and pain can often be localized.
Abdominal tenderness spans a spectrum from mild tenderness to severe pain associated with peritonitis. Rebound tenderness is seen commonly with peritonitis. Rebound tenderness occurs when the membrane that lines the abdominal cavity (the peritoneum) is irritated, inflamed, or infected (peritonitis). Guarding is a term used to describe the tensing of abdominal wall muscles when the abdomen is palpated. It is also associated with peritonitis. Point tenderness is a more general term which defines tenderness in a particular location.
The most common recognized point tenderness is that of McBurney. The McBurney point is located by drawing a line from the navel to the highest part of the pelvic bone on the right side (the right iliac crest). Divide the line into three equal lengths. McBurney's point is 2/3 of the way from the navel to the iliac crest. Pressure over this point will elicit pain in people with appendicitis who have been symptomatic for a period of time.
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| Home Care: |
Consult your health care provider.
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| Call your health care provider if: |
Any person with point tenderness should call and be examined promptly by the health care provider!
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| What to expect at your health care provider's office: |
The medical history will be obtained and a physical examination performed.
Medical history questions documenting point tenderness in detail may include:
- Time pattern
- When did the abdominal pain associated with this point tenderness develop?
- Is this the first time that this kind of discomfort has occurred?
- If it has occurred before, have you noticed any pattern to the occurrences?
- Other
- What other symptoms are also present?
- Is there vomiting?
- Is there rebound tenderness (the tenderness is worse when the area is gently pressed and then the pressure is suddenly released).
- Is there diarrhea or constipation?
- Is there a fever?
The physical examination will include a detailed abdominal examination.
Diagnostic testing may include:
Interventions:
Sometimes, the history and physical examination will indicate a need for immediate surgery (an exploratory laparotomy or an emergency appendectomy). This is usually the case if signs of diffuse peritonitis are present.
After seeing your health care provider:
You may want to add a diagnosis related to point tenderness to your personal medical record.
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Review Date: 8/12/2001
Reviewed By: Robert W. O'Rourke, M.D., Department of Minimally Invasive Surgery, Legacy Health System, Portland, OR. Review provided by VeriMed Healthcare Network.
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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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