Move to the patient's left side. Place your right hand behind the patient, just below and parallel to the 12th rib, with your fingertips just reaching the CVA. Lift, trying to displace the kidney anteriorly. Place your left hand gently in the LUQ, lateral and parallel to the rectus muscle. Ask the patient to take a deep breath. At the peak of inspiration, press your left hand firmly and deeply into the LUQ, just below the costal margin. Try to "capture" the kidney between your two hands. Ask the patient to breathe out and then to stop breathing briefly. Slowly release the pressure of your left hand, feeling at the same time for the kidney to slide back into its expiratory position. If the kidney is palpable, describe its size, contour, and any tenderness.
Alternatively, try to palpate the left kidney using the deep palpation technique similar to palpation of the spleen. Standing at the patient's right side, with your left hand, reach over and around the patient to lift up beneath the left kidney, and with your right hand, feel deep in the LUQ. Ask the patient to take a deep breath, and feel for a mass. A normal left kidney is rarely palpable.
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