Patients with horseshoe kidney usually appear well and in majority of cases horseshoe kidney is an incidental finding during radiological examination. Physical examination of patients with horseshoe kidney is usually remarkable for abdominal distension, palpable kidney, costovertebral tenderness and palpable bladder.

Physical examination of patients with horseshoe kidney is usually remarkable for abdominal distension, palpable kidney, costovertebral tenderness and palpable bladder.^[1][2]

• Patients with horseshoe kidney usually appear well.

• High grade/low grade fever if infection is presen.
• Tachycardia with a regular pulse because of the fever which is due to infection.
• High blood pressure due to salt retention.

• Skin examination of patients with horseshoe kidney is usually normal.

• HEENT examination of patients with horseshoe kidney usually unremarkable.

• Neck examination of patients with horseshoe kidney is usually normal.

• Pulmonary examination of patients with horseshoe kidney usually normal.

• Cardiovascular examination of patients with horseshoe kidney is usually normal.

• Abdominal distention.
• Abdominal tenderness.
• A lower mid-line palpable abdominal mass.

• Costovertebral angle tenderness can be present due to renal stone, infection or hydronephrosis.

• Rectal examination should be performed in patients with hydronephrosis to assess:
  • Sphincter tone
  • Prostate

• Neuromuscular examination of patients with horseshoe kidney is usually normal.

• Extremities examination of patients with horseshoe kidney is usually normal.