Pleural Disorders - Diagnosis - Diagnosis

Your doctor will want to learn about your signs and symptoms, risk factors, personal health history, and family health history to determine whether you have a pleural disorder and, if so, what kind.

To help diagnose a pleural disorder, your doctor may ask you to describe any chest pain, including details such as the following:

• What it feels like
• Where it is located and whether you can feel it in your arms, jaw, or shoulders
• When it started and whether it goes away and then comes back
• What makes it better or worse

This information about the chest pain you have experienced can help your doctor determine whether it is caused by problems with your heart, chest muscles, lungs, or digestive system.

As part of a physical examination, your doctor will measure your blood pressure and heart rate, feel your chest and belly, take your temperature, listen to your heart and lungs, and feel your pulse. Your doctor may also check the level of oxygen in your blood with a probe on your finger or forehead.

Your doctor will listen to your breathing to find out whether your lungs are making any abnormal sounds.

• If you have pleurisy, the inflamed layers of the pleura may make a rough, scratchy sound as they rub against each other when you breathe. Doctors call this a pleural friction rub.
• If you have a pleural effusion, fluid buildup in the pleural space may prevent a friction rub. But if you have a lot of fluid, your doctor may hear a dull sound when he or she taps on your chest.
• If you have a pneumothorax, your doctor may hear more echo than usual when he or she taps on your chest.

Your doctor may order a combination of the following tests to help diagnose a pleural disorder.

• Biopsy to retrieve a sample of the pleura. The sample is checked for signs of disease.
• Blood tests to show whether you have an illness that increases your risk of pleurisy or another pleural disorder
• Chest CT scan to find pockets of fluid or air and signs of pneumonia, a lung abscess, tumors, blood clots, or other possible causes of pleural disorders
• Chest MRI to look for possible causes of pleural disorders or confirm results of other imaging tests, such as a chest CT scan
• Chest X-ray to look for air or fluid in the pleural space, problems with the lung or pleura, or an underlying cause of a pleural disorder, such as pneumonia, a fractured rib, or a lung tumor
• Endoscopy to look for signs of disease, guide the doctor while performing a biopsy, or remove pleural fluid
• Thoracentesis to remove a sample of pleural fluid for testing. The fluid removed during thoracentesis is tested and examined under a microscope for signs of infection, cancer, or other conditions that can cause fluid or blood to build up in the pleural space.
• Ultrasound to look for fluid, air, or other abnormal findings in your chest

Your doctor may order the following tests to help rule out other medical conditions that can cause chest pain.

• Blood tests to rule out other medical conditions affecting the heart, liver, kidneys, or other chronic inflammatory diseases that can cause pleural disorders
• Chest X-ray to look for signs of pneumonia or other serious problems
• CT angiography to take pictures of your blood vessels and look for blood clots in the lungs. This can help rule out pulmonary embolism, a type of venous thromboembolism.
• Electrocardiogram to measure your heartbeat and rule out a heart problem such as heart attack or pericarditis, a type of heart inflammation
• Echocardiography to look for an aortic aneurysm or signs of damage to your heart

• Return to Risk Factors to review family history, lifestyle, or other medical conditions that increase your risk of developing pleural disorders.
• Return to Signs, Symptoms, and Complications to review common signs and symptoms of pleural disorders.