Pleural friction rub

Pleural friction rub is a medical term referring to a specific sound heard through a stethoscope during a physical examination of the lungs. This sound is produced when the two layers of the pleura, the thin membranes that line the lungs and the inside of the chest wall, rub against each other. This can occur when the normally smooth, lubricated surfaces of the pleura become roughened or inflamed, a condition known as pleurisy.

Causes

Pleural friction rub is most commonly associated with pleurisy, which can be caused by a variety of conditions including pneumonia, tuberculosis, lung cancer, and autoimmune diseases such as rheumatoid arthritis and lupus. It can also occur in the presence of a pulmonary embolism or after a pneumothorax.

Symptoms

The primary symptom associated with a pleural friction rub is a sharp, grating or creaking sound that can be heard when the patient breathes in or out. This sound is often described as similar to the noise made by walking on fresh snow. Other symptoms can include chest pain, shortness of breath, and a persistent cough.

Diagnosis

Diagnosis of a pleural friction rub is typically made during a physical examination using a stethoscope. The sound is best heard when the patient is sitting up and leaning forward. Additional tests, such as a chest X-ray, CT scan, or ultrasound may be used to confirm the diagnosis and identify the underlying cause.

Treatment

Treatment for a pleural friction rub focuses on addressing the underlying cause of the pleurisy. This can include antibiotics for infections, anti-inflammatory drugs for autoimmune conditions, or other treatments as appropriate. In some cases, a procedure known as a thoracentesis may be performed to remove excess fluid from the pleural space.

See also

• Auscultation
• Respiratory system
• Pleural effusion