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Pleurisy - pleuritis
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Pleurisy - pleuritis

Diseases & Conditions A-Z

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ASTHMA & RESPIRATORY SYSTEM
Respiratory System

Pleurisy occurs when the double membrane (pleura) that lines the chest cavity and surrounds each of your lungs becomes inflamed. The condition, also called pleuritis, typically causes sharp pain, almost always during the act of breathing.

One layer of the pleura, which is just a few cells thick, overlies each lung. The other layer lines the inner chest wall. When you breathe in, the large muscle separating the chest cavity from the abdominal cavity (diaphragm) contracts and your chest wall expands, causing your lungs to expand. The two layers of pleura are like two pieces of smooth satin rubbing against each other with almost no friction, allowing your lungs to expand and contract without any resistance from the lining of the chest wall.

Screening and diagnosis

Your doctor may make a diagnosis based on your signs and symptoms. Upon examining you and listening to your chest, your doctor may hear a "friction rub" that sometimes sounds like the crunching sound of walking on very dry snow.

You may also undergo the following diagnostic procedures:

  • Imaging. A chest X-ray may show an area of inflammation in your lungs that indicates pneumonia. Your doctor will want to investigate an unexplained abnormality seen on an X-ray with additional imaging, usually beginning with a computerized tomography (CT) scan. In a CT procedure, a computer translates information from X-rays into images of thin sections (slices) of your chest. CT scans produce more detailed images of your internal organs than do conventional X-ray studies. Sometimes doctors want a special type of chest X-ray in which you lie on your side where the pleurisy is to see if there's any fluid that doesn't appear on a standard chest X-ray. This type of X-ray is called a decubitus chest X-ray.

  • Blood test. A blood test may tell your doctor whether your lungs are infected and what type of infection you have. Other blood tests may also detect an autoimmune disorder such as rheumatoid arthritis or lupus in which the initial sign is pleurisy.

  • Thoracentesis. To remove fluid for laboratory analysis, your doctor may suggest a procedure called thoracentesis. In this procedure, your doctor first injects a local anesthetic, then inserts a needle through your chest wall between your ribs to remove fluid. In addition, a sample of tissue (pleural biopsy) for microscopic analysis may be obtained if your doctor is concerned that the fluid collection may be caused by tuberculosis or cancer. If only a small amount of fluid is present, your doctor may insert the needle with the help of ultrasound over the site of the fluid.

  • Video-assisted thoracic surgery (VATS). Another way of obtaining a sample of pleural tissue is by a surgical procedure called video-assisted thoracic surgery. In VATS, a tube is inserted to collapse a lung to about one-quarter its normal size. This creates a space through which your doctor can insert a pen-sized instrument through your chest wall to take a tissue sample under video guidance.

Pleurisy > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/15/08 01:51 AM