Pleural effusion diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
Because the treatment of pleural effusion varies based on the cause it is important to have a good differential diagnosis. This would drive the diagnostic approach and ultimately the diagnostic study of choice based on the presentation. <ref name="pmid31315808">{{cite journal| author=Jany B, Welte T| title=Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. | journal=Dtsch Arztebl Int | year= 2019 | volume= 116 | issue= 21 | pages= 377-386 | pmid=31315808 | doi=10.3238/arztebl.2019.0377 | pmc=6647819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31315808 }} </ref> | Because the treatment of pleural effusion varies based on the cause it is important to have a good differential diagnosis. This would drive the diagnostic approach and ultimately the diagnostic study of choice based on the presentation. After determining whether the effusion is unilateral or bilateral through chest x-ray, the likely cause should be considered. If the diagnosis is clearly pointing towards nephrotic syndrome or congestive heart failure, then these patients do not necessarily need to have a thoracocentesis performed and should be treated. However, a thoracocentesis becomes the diagnostic study of choice in the following circumstances: | ||
* an unclear cause | |||
* patient experiencing pleuritic chest pain | |||
* patient experiencing symptoms out of proportion to the size of the effusion | |||
* no response to treatment | |||
The use of thoracocentesis becomes urgent if the patient is decompensating or the pleural effusion is considerabley large. <ref name="pmid31315808">{{cite journal| author=Jany B, Welte T| title=Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. | journal=Dtsch Arztebl Int | year= 2019 | volume= 116 | issue= 21 | pages= 377-386 | pmid=31315808 | doi=10.3238/arztebl.2019.0377 | pmc=6647819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31315808 }} </ref> | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
Revision as of 18:25, 30 March 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD
Overview
Because the treatment of pleural effusion varies based on the cause it is important to have a good differential diagnosis. This would drive the diagnostic approach and ultimately the diagnostic study of choice based on the presentation. After determining whether the effusion is unilateral or bilateral through chest x-ray, the likely cause should be considered. If the diagnosis is clearly pointing towards nephrotic syndrome or congestive heart failure, then these patients do not necessarily need to have a thoracocentesis performed and should be treated. However, a thoracocentesis becomes the diagnostic study of choice in the following circumstances:
- an unclear cause
- patient experiencing pleuritic chest pain
- patient experiencing symptoms out of proportion to the size of the effusion
- no response to treatment
The use of thoracocentesis becomes urgent if the patient is decompensating or the pleural effusion is considerabley large. [1]
Diagnostic Study of Choice
Study of choice
References
- ↑ Jany B, Welte T (2019). "Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment". Dtsch Arztebl Int. 116 (21): 377–386. doi:10.3238/arztebl.2019.0377. PMC 6647819 Check
|pmc=value (help). PMID 31315808.