What did the doctor think I had?

May 10, 2012 6:39 PM

What is a doctor looking for if he palpates the kidney area and asks if it is painful?

I had a slightly strange interaction with an ER doctor last weekend. I went to the emergency room for a non-illness-related reason (I needed help removing a menstrual cup) and the doctor and nurse were very personable and helpful. After taking out the cup for me, the doctor instructed me to get dressed, and left the room. He immediately returned, just as I started to get dressed, and said something like "Can I just check something?" Then he pressed (palpated?) the areas below my ribcage on either side of my belly and asked if it hurt. I was a bit surprised, but said no, and before I could ask him why he was checking, he hurried out of the room. What could he have been checking for? Is it even possible to guess? (I never mentioned any symptoms or said I was feeling unwell.)

posted by smilingtiger to Health & Fitness (7 answers total)

I suppose he was checking for inflammation of the kidneys (nephritis, which can be caused by a lot of things) but I have no idea what that would have to do with a Diva cup. Perhaps he noticed something else about your presentation and thought there was a small chance you also have nephritis and was checking just in case?
posted by imagineerit at 6:58 PM on May 10, 2012

Best answer: Had he examined your abdomen before that? Because my first guess would be that he forgot to do an abdominal exam and needed to document one.

The area below your ribcage is actually where you would palpate for gallbladder issues (on the right), and stomach on your left. To check for kidney pain we hit your costovertebral angle (just under your ribs on your back)
posted by treehorn+bunny at 6:59 PM on May 10, 2012 [4 favorites]

Best answer: He was checking for "flank pain" which may present with urinary tract infection or kidney infection. My best guess? He had never had an experience with menstrual cups before and likely didn't really know what they were or much about them, but it was easy enough to remove once he visualized it, so he did. Then, as he was charting, he either discussed the removal with a colleague or mused about it himself and something along the lines of "I wonder if this situation might have manually introduced bacteria into the urinary tract because the cup may hold and overgrow bacteria, and the cup gets manipulated a lot and this is something this patient does regularly." Then, so he could chart that he actually assessed your whole GU system without lying or missing something big, dashed in and palpated for flank pain, giving your GU system the all clear.
posted by rumposinc at 6:59 PM on May 10, 2012

Ooops--I missed where you said below your BELLY. Not flank pain. But, similarly, he was ruling out any organ involvement. Both areas are palpated for liver and/or spleen enlargement or tenderness--routine when you mess with the GU system. Likely he was charting and realized he forgot to do an abdominal assessment.
posted by rumposinc at 7:02 PM on May 10, 2012 [3 favorites]

My doctor does this every time she does a full physical exam. I think it's just on the doctor checklist of annoying pokey stuff.
posted by SMPA at 7:47 PM on May 10, 2012 [1 favorite]

Best answer: If a doctor's trying to palpate your kidneys, they should be poking around your back just below your ribcage. I would say that he was trying to rule out pelvic inflammatory disease as a complication of retained foreign body in the vagina.
posted by chiquitita at 3:18 AM on May 11, 2012

It was not the issue you presented with, but the palpation sounds like the way a doctor would check for a Abdominal aortic aneurysm.
posted by mlis at 10:51 PM on May 11, 2012