The Carnett sign describes an examination finding used to distinguish pain arising from the abdominal wall from pain arising from within the abdomen itself.
Testing for Carnett sign is performed as a two-stage procedure:
the examiner locates the point of maximal tenderness through palpation of the abdomen with the patient's abdominal muscles relaxed
the patient then tenses their abdominal muscles (for example, by lifting their head from the pillow or raising their legs with the knees straightened) and the examiner then applies pressure to the same point of tenderness
The test is postive if the pain remains the same or worsens with tension of the rectus muscles. A positive test is suggestive that the source of the pain is within the abdominal wall as opposed to the abdominal cavity. Differentials of a postive test include anterior cutaneous nerve entrapment and rectus sheath hematoma 1.
History and etymology
The sign was first described in 1926 by John Berton Carnett (1890–1988), an American surgeon 2.
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