Pleural friction rub
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: [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
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-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