Pleural friction rub

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.

Differential Diagnosis
In alphabetical order:


 * Asbestos-induced pleural disease
 * Bornholm disease
 * Chest wall tumors
 * Devil's grip
 * Drug induced pleural disease
 * Epidemic dry pleurisy
 * Epidemic myalgia
 * Estrogen preparations
 * Hemothorax
 * Major surgery
 * Mesothelioma
 * Neoplasm
 * Pancreatic pleurisy
 * Pleural effusion
 * Pleurisy
 * Pleuritis
 * Pleurodynia
 * Pneumonia
 * Pulmonary infarction
 * Pulmonary metastases
 * Radiation therapy
 * Recurrent polyserositis
 * Rheumatic pleural effusion
 * Rheumatoid arthritis
 * Subphrenic/intra-abdominal abscess
 * Systemic lupus erythematosus
 * Trauma
 * Tuberculosis
 * Viral pleurisy

History and Symptoms
Distinguish between pleural rub and pericardial rub

Laboratory Findings

 * Labs include
 * blood and sputum cultures
 * calcium
 * CBC with differential
 * BUN / Creatinine
 * electrolytes
 * glucose
 * pulse oximetry

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-dimmer assay

Other Diagnostic Studies

 * Thoracentesis

Treatment

 * Administer supplemental oxygen

Acute Pharmacotherapies

 * NSAIDs
 * narcotics
 * chest wraps if pain is present

Primary Prevention

 * Isolation if TB or influenza are suspected