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Percussion of the kidneys. The kidneys are located in the retroperitoneum and are well-protected by both ribs and muscles of the back. The upper pole of the left kidney can be found at the level of the 12th thoracic vertebra. Because of the liver, the right kidney lies around 3 cm, or about 1 inch, lower than the left. Careful percussion of the flanks in the lower rib cage area should not elicit pain in a healthy patient. Pain on percussion, however, should raise suspicion for a pathological process, such as pyelonephritis or urolithiasis.
