Pleural friction rub: Difference between revisions
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Revision as of 18:59, 13 February 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pleural friction rubs are:
- "Creaking leathery" lung sound
- 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.
Differential Diagnosis
In alphabetical order: [1] [2]
- 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
History and Symptoms
Distinguish between pleural rub and pericardial rub
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
MRI and CT
- Spiral CT
Other Imaging Findings
- V/Q scan
- Pulmonary angiogram
- Arterial blood gas
- D-dimmer assay
Other Diagnostic Studies
- Thoracentesis
Treatment
- Administer supplemental oxygen
Acute Pharmacotherapies
- NSAIDs
- narcotics
- chest wraps if pain is present
Primary Prevention
- Isolation if TB or influenza are suspected