Physical Exam

Abdominal Wall Tenderness Test

also known as Carnett's sign

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Video coming September 2026

How to Perform

With the patient supine, find the point of maximum tenderness and hold pressure there. Ask the patient to fold their arms across the chest and tense the abdominal wall by lifting the head and shoulders off the table, then reapply the same pressure. A positive test is tenderness that is unchanged or increased when the abdominal wall is tensed.

How to Interpret

Abdominal Wall Pain

Carnett's test positive

Rule in

Somewhat helpful

Rule out

Somewhat helpful

Evidence:Limited

Psychogenic Abdominal Pain

Carnett's test positive

Rule in

Somewhat helpful

Rule out

Helpful

Evidence:Limited

References

Takada T, Ikusaka M, Ohira Y, Noda K, Tsukamoto T. Diagnostic usefulness of Carnett's test in psychogenic abdominal pain. Intern Med. 2011;50(3):213-217. doi:10.2169/internalmedicine.50.4179. PMID: 21297322.
van Assen T, de Jager-Kievit JWAJ, Scheltinga MR, Roumen RMH. Chronic abdominal wall pain misdiagnosed as functional abdominal pain. J Am Board Fam Med. 2013;26(6):738-744. doi:10.3122/jabfm.2013.06.130115. PMID: 24204070.
Yale SH, Tekiner H, Yale ES. Fothergill and Carnett signs and rectus sheath hematoma. J Rural Med. 2020;15(3):130-131. doi:10.2185/jrm.2019-019. PMID: 32704339.
Takada T, Ikusaka M, Ohira Y, Noda K, Tsukamoto T. Diagnostic usefulness of Carnett's test in psychogenic abdominal pain. Intern Med. 2011;50(3):213-7. PMID: 21297322.
Thomson H, Francis DM. Abdominal-wall tenderness: a useful sign in the acute abdomen. Lancet. 1977;2(8047):1053-1054. doi:10.1016/s0140-6736(77)91885-2. PMID: 72957.
Carnett JB. Intercostal neuralgia as a cause of abdominal pain and tenderness. Surg Gynecol Obstet. 1926;42:625-632.