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. 2015 Feb 8;23:19. doi: 10.1186/s13049-015-0096-0

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© van Assen et al.; licensee BioMed Central. 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Typical findings during physical examination in an ACNES patient. A. Trigger point is localized using palpating index finger. Tenderness increases when abdominal muscles are tensed as the patient lifts the head (Carnett’s test); B. Skin gnostic sensibility is determined using a swab. The shaded area overlying the trigger point reflects altered sensibility; C. A cold alcohol gauze is utilized to test the vital sensibility; D. By squeezing a fold containing the patient’s skin and subcutaneous fat between thumb and index finger, the area of interest hurts compared to the contralateral side (‘pinch test’).