Physical Exam

Abdominal Wall Tenderness Test

also known as Carnett sign

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Video coming September 2026

How to Perform

With the patient supine, palpate the abdomen directly on skin to identify the point of maximum tenderness and maintain pressure there. Ask the patient to cross their arms over the chest and lift the head and shoulders off the table to tense the abdominal wall. The test is positive if the tenderness increases.

How to Interpret

Abdominal Wall Pain

Carnett test positive

Rule in

Somewhat helpfulDerived CI

Rule out

Somewhat helpfulDerived CI

Evidence:Limited

Psychogenic Abdominal Pain

Carnett 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.

Research last updated September 10, 2026.