Physical examination maneuver

Physical Exam

Renal Artery Auscultation

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How to Perform

With the patient supine and the abdomen relaxed, place the diaphragm of the stethoscope (firm pressure with a tunable stethoscope) directly on skin a few centimeters superior and lateral to the umbilicus. Listen for a bruit, particularly a combined systolic-diastolic bruit, during a held breath or quiet breathing. Auscultate both sides.

How to Interpret

Showing all 2 findings

Renovascular Hypertension

Continuous (systolic-diastolic) abdominal bruit
Rule in
Very helpful
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Any abdominal or flank bruit, including an isolated systolic bruit
Rule in
Helpful
Rule out
Somewhat helpfulDerived CI
Evidence:ModerateResearch in progress

Related Bedside Tests

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Abdomen Auscultation
Rule in:VHRenovascular Hypertension, MHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more
Rule out:MHRenovascular Hypertension, NHBowel Obstruction, IEAbdominal Aortic Aneurysm +9 more
🎬Video coming soon
Abdomen Inspection
Rule in:VHBowel Obstruction, SHAscites, ICCushing Syndrome +3 more
Rule out:SHAscites, SHBowel Obstruction, NHCushing Syndrome +3 more
🎬Video coming soon
Abdominal Aorta Palpation
Rule in:VHAbdominal Aortic Aneurysm
Rule out:MHAbdominal Aortic Aneurysm
🎬Video coming soon
Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
🎬Video coming soon
Femoral Artery Palpation
Rule in:VHAortic Coarctation, VHFemoral False Aneurysm, SHAortoiliac Occlusive Disease +1 more
Rule out:VHFemoral False Aneurysm, NHAortic Coarctation, ICAortoiliac Occlusive Disease +1 more
🎬Video coming soon
Abdomen Palpation
Rule in:VHExtrahepatic Biliary Obstruction, VHIntussusception, VHPyloric Stenosis +32 more
Rule out:VHHepatocellular Jaundice, HAppendicitis, SHDiverticulitis +32 more

Related Systems / Regions

AbdomenCardiovascularGenitourinary

Related Diagnoses

Renovascular Hypertension

Related Chief Complaints

Abdominal BruitDifficult-to-control Blood PressureFlank PainHeadacheHigh Blood PressureIncidental FindingKidney ImpairmentResistant HypertensionSudden Worsening of Blood Pressure

References

Research in progress on one or more findings above; ratings may change.

  • Grim CE, Luft FC, Weinberger MH, Grim CM. Sensitivity and specificity of screening tests for renal vascular hypertension. Ann Intern Med. 1979 Oct;91(4):617-622. doi:10.7326/0003-4819-91-4-617. PMID 484965.
  • Turnbull JM. The rational clinical examination. Is listening for abdominal bruits useful in the evaluation of hypertension? JAMA. 1995;274(16):1299-1301. PMID: 7563536.
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 9, 2026.