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How Do I Know If I Have It?

Oftentimes, the distinctive pain caused by pleurisy is an important clue to your doctor. In addition, your doctor will listen to your chest with a stethoscope as you breathe. If this examination reveals pleural friction rub — the abrasive sound of the pleura's two layers sliding against each other — the diagnosis is clear.

Pleural friction rub produces a scraping, raspy sound that occurs at the end of your inhalation and the beginning of your exhalation, and it comes from the area directly over the pleural inflammation. A decrease in breath sounds and a change in their quality may allow your doctor to diagnose a pleural effusion.

Your doctor may also take X-rays of your chest, which will be normal if you have pleurisy but show the fluid of a pleural effusion. CT scans and ultrasound scans may also be used to better visualize the chest cavity.

If there is fluid present, your doctor may draw a sample of pleural fluid for analysis. Your doctor will determine the exact location of the fluid. Then, after injecting your back or chest with a local anesthetic, your doctor will use a syringe to extract the fluid in a procedure called thoracentesis. The doctor will run tests on the sample to determine the underlying cause of the fluid buildup.

Occasionally, your doctor may request a biopsy of the pleura to better analyze the tissue and determine the cause of the pleurisy. A sample of pleural tissue can be obtained several ways: with a biopsy needle, by making a small incision in the chest wall, or by using a thoracoscope (a video-assisted instrument for viewing the chest cavity and collecting samples).

What Are the Treatments?

Once the underlying cause of your pleurisy is identified, your doctor will take steps to treat it such as administering antibiotics for an infection. In addition to this, disease, your doctor will probably prescribe anti-inflammatory drugs or pain medicines, such as aspirin, to remedy the inflammation. Sometimes, a codeine-based cough syrup will be prescribed to control a painful cough.

In the case of pleural effusion, your doctor will direct treatment towards the underlying cause of the fluid. If the amount of pleural fluid is excessive, the doctor may drain it through a tube inserted in your chest, a procedure that requires hospitalization.

How Can I Prevent It?

Pleurisy usually is caused by an infection or a disease like lupus. While the condition probably can't be prevented, it could indicate a larger underlying problem that your doctor should know about right away.