What physical exam finding is indicative of a kidney stone?

CVA tenderness, or costovertebral angle tenderness, is a key physical exam finding associated with kidney stones. It occurs when pressure is applied to the areas where the kidneys are located, typically at the lower back or flanks just above the level of the kidneys. When a kidney stone causes irritation or obstruction in the urinary tract, this can lead to inflammation or stretching of the kidney capsule, which results in tenderness in these areas.

This clinical sign is particularly important because it can suggest the presence of nephrolithiasis (kidney stones) or other renal pathologies such as pyelonephritis. Patients experiencing kidney stones often report sharp pain, and CVA tenderness is frequently noted during the examination.

The other options presented do not correlate with kidney stones in the same way. For example, bradycardia is related to heart rate and not typically associated with renal dysfunction or stone presence. Lumbar rigidity tends to indicate musculoskeletal issues, while rales in the lungs point to pulmonary conditions, not kidney-related issues.