From the Guidelines
Pleuritic friction rub is a distinctive scratchy, grating sound heard through a stethoscope when a patient breathes, resulting from the inflamed pleural surfaces rubbing against each other during respiration. This sound occurs due to inflammation of the pleural surfaces, which can be caused by various conditions such as pleurisy, pneumonia, pulmonary embolism, or lung cancer, as discussed in the context of pleural disease management 1. The key characteristics of a pleuritic friction rub include:
- A scratchy, grating sound heard during both inspiration and expiration
- Typically most audible over the lower lateral chest wall
- Often accompanied by sharp chest pain that worsens with breathing
- Described as similar to leather rubbing together or walking on fresh snow The presence of a pleuritic friction rub is clinically significant as it indicates active pleural inflammation, helping to differentiate pleurisy from other causes of chest pain, and its resolution depends on addressing the underlying cause of the inflammation, as would be considered in the management of pleural infection according to the British Thoracic Society guideline 1. Treatment, therefore, focuses on the underlying cause rather than the friction rub itself, which will resolve once the inflammation subsides.
From the Research
Definition and Characteristics
- Pleuritic friction rub is not directly defined in the provided study 2
- However, the study discusses pleuritic chest pain, which is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling 2
Related Conditions
- Pleuritic chest pain can be caused by various conditions, including pulmonary embolism, myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax 2
- Viruses are also common causative agents of pleuritic chest pain, with examples including Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus 2
Diagnosis and Treatment
- Diagnosis of the underlying cause of pleuritic chest pain is crucial for guiding treatment 2
- Validated clinical decision rules can be employed to help exclude coronary artery disease and guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography 2
- Treatment is guided by the underlying diagnosis, with nonsteroidal anti-inflammatory drugs being appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain 2