Pleural friction rub

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pleural friction rubs are creaking leathery lung sounds, that is both inspiratory and expiratory. Pleural and visceral linings become inflamed due to rubbing during the respiratory process. Sound is consistent through inhalation and exhalation. Pleural rubbing is characteristic of pleurisy and is associated with pleural effusion and chest pain when breathing.

Causes

Causes in Alphabetical Order:

• Asbestos-induced pleural disease
• Bornholm disease
• Chest wall tumors
• Devil's grip
• Drug induced pleural disease
• Epidemic dry pleurisy
• Epidemic myalgia
• Estrogen preparations
• Hemothorax
• Major surgery
• Mesothelioma
• Neoplasm
• Pancreatic pleurisy
• Pleural effusion
• Pleurisy
• Pleuritis
• Pleurodynia
• Pneumonia
• Pulmonary infarction
• Pulmonary metastases
• Radiation therapy
• Recurrent polyserositis
• Rheumatic pleural effusion
• Rheumatoid arthritis
• Subphrenic/intra-abdominal abscess
• Systemic lupus erythematosus
• Trauma
• Tuberculosis
• Viral pleurisy

Diagnosis

Laboratory Findings

• Labs include

• Blood and sputum cultures
• Calcium
• CBC with differential
• BUN / Creatinine
• Electrolytes
• Glucose
• Pulse oximetry

Chest X Ray

• May show pleural effusion and could possibly reveal underlying problems

CT

• Spiral CT

Other Imaging Findings

• V/Q scan
• Pulmonary angiogram
• Arterial blood gas
• D-dimer assay

Other Diagnostic Studies

• Thoracentesis

Treatment

Medical Therapy

• Administer supplemental oxygen

Acute Pharmacotherapies

• NSAIDs
• Narcotics
• Chest wraps if pain is present

Prevention

• Isolation if TB or influenza are suspected