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Carnett’s test, or sign, is used to help differentiate between abdominal wall pain and intra-abdominal pathology. If the patient’s pain can be attributed to the abdominal wall, they may be at lower risk of serious abdominal pathology and thus, require less workup.

Performing the Test

  1. Have the patient lie in the supine position
  2. Palpate the point of focal pain on the abdomen
  3. Ask the patient to rate their pain at that point
  4. Have the patient perform a partial sit-up, elevating their head off the bed; this will tense the patient’s abdominal muscles
  5. If the partial sit-up causes increased pain, the test is considered positive for abdominal wall pain and likely does not indicate intra-abdominal pain

Interpretation

  • In the emergency room setting, the test has been shown to have poor positive (2.3) and negative (0.5) likelihood ratios for detecting abdominal wall pathology as the cause of pain.

References

  1. Young SE, Levsky ME, DeKay KB, Dunn JD. A Prospective Evaluation of Carnett’s Test for Acute Abdominal Pain in the Emergency Department. Annals of Emergency Medicine. 2007; 50(3,1)