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 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.

Causes

In alphabetical order: [1] [2]

Diagnosis

Laboratory Findings

  • Labs include

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

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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