How is pleurisy diagnosed?
The pain of pleurisy is very distinctive. The pain is in the chest and is usually sharp and aggravated by breathing. However, the pain can be confused with the pain of: • Inflammation around the heart (pericarditis) • Heart attack (myocardial infarction) • Air leak inside the chest (pneumothorax) To make the diagnosis of pleurisy, the doctor examines the chest in the area of pain and can often hear (with a stethoscope) the friction that is generated by the rubbing of the two inflamed layers of pleura with each breath. The noise generated by this sound is termed a pleural friction rub. (In contrast, the friction of the rubbing that is heard with pericarditis is synchronous with the heartbeat and does not vary with respiration.) With large amounts of pleural fluid accumulation, there can be decreased breath sounds (less audible respiratory sounds heard through a stethoscope) and the chest is dull sounding when the doctor drums on it (dullness upon percussion). A chest x-ray in the uprigh
