What does Lloyd's sign indicate when tenderness is found in the lower back upon percussion?

• A. Presence of a lower urinary tract infection
• B. Presence of an upper urinary tract infection
• C. Kidney stones
• D. Bladder inflammation

Answer: (B)

Lloyd's sign, which manifests as tenderness in the lower back when percussion is applied, is indicative of potential renal involvement, specifically relating to the kidneys. This sign is often assessed during a physical examination to evaluate for the presence of an upper urinary tract infection, commonly known as pyelonephritis.

The rationale behind this is tied to the anatomical correlation between the kidneys and the back. When the kidneys become inflamed or infected, such as in the case of pyelonephritis, it can lead to irritation of the surrounding tissues, which in turn makes the area more sensitive to percussion. Thus, a positive Lloyd's sign suggests that there could be an underlying infection affecting the upper urinary tract.

This is distinct from conditions like lower urinary tract infections, kidney stones, or bladder inflammation, which would not typically produce the same percussion tenderness in the lumbar region that is characteristic of upper urinary tract issues. Each of these other conditions presents with different signs and symptoms that do not align with the specific manifestation of Lloyd's sign.