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Kidney & Urinary Signs

Signs of the kidneys and urinary tract: loin tenderness, bladder and kidney palpation, the half-and-half nails of chronic kidney disease, and the scrotal examination signs — including the ones used when a twisted testicle is suspected.

This page lists all 12 of them in the guide. Open any sign for how it is elicited, what it suggests, and its eponym story where it has one.

SignSystemA positive finding is associated with
Bag-of-worms varicoceleKidney & UrinaryAssociated with varicocele — dilated veins of the spermatic cord; a new right-sided or non-reducing varicocele can be associated with abdominal or kidney pathology.
Ballotable kidneyKidney & UrinaryAssociated with kidney enlargement, as in polycystic kidney disease, tumours or hydronephrosis.
Blue dot signKidney & UrinaryAssociated with twisting (torsion) of the appendix testis, a small harmless remnant — a mimic of testicular torsion.
Cremasteric reflexKidney & UrinaryAbsence on the painful side is associated with testicular torsion; the reflex may also be absent in some normal boys.
Dietl's crisisKidney & UrinaryAssociated with intermittent obstruction at the junction of the kidney and ureter (pelviureteric junction obstruction).
Lindsay's nailsKidney & UrinaryAssociated with chronic kidney disease and uraemia.
Palpable bladderKidney & UrinaryAssociated with urinary retention, classically from prostate enlargement or a blocked catheter.
Pasternatsky's signKidney & UrinaryAssociated with inflammation or infection of the kidney, classically acute pyelonephritis, and with obstructing kidney stones.
Periorbital oedemaKidney & UrinaryAssociated with nephrotic syndrome, though allergies and other causes are also common.
Prehn's signKidney & UrinaryUsed traditionally to help distinguish epididymitis from testicular torsion, though it is unreliable and must never delay urgent assessment of a painful scrotum.
Renal artery bruitKidney & UrinaryAssociated with renal artery stenosis, one cause of secondary hypertension and declining kidney function.
Transillumination of a scrotal swellingKidney & UrinaryA glowing swelling is associated with a hydrocele (fluid around the testicle); failure to transilluminate is associated with hernia or solid masses.
Please note: This page is an educational reference about clinical examination signs. A clinical sign supports — and never replaces — a full clinical evaluation, examination and appropriate testing. A sign being present does not by itself prove a diagnosis, and an absent sign does not rule one out. If you have symptoms that worry you, see a health professional.