Clinical Pearl Wednesday #66

Abdominal Pain Pain Appendicitis  - derneuemann / Pixabay

Have a patient with acute or chronic abdominal pain? Perform the Carnett maneuver on them.

Often times, abdominal pain is from the abdominal wall muscles vs. inside the abdomen. The Carnett maneuver will help you determine this.

The test is simple: have the patient lay down and ask them to either raise their legs or torso in a “crunch” like movement. This activates and tenses the abdominal muscles.

If the pain increases at the site the pain is felt, then it is very unlikely that the pain is originating from inside the abdomen. It is likely coming from the abdominal musculature instead.

I have used this maneuver multiple times in the urgent care and ER settings with favorable results. It is very reassuring to the patient and sometimes you will find out with further history that they recently began working out or did 100 crunches 2-3 days prior. Easy diagnosis!

As always, use your clinical judgement when assessing abdominal pain.

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