Pleural rub

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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98 Pleural rub

Instruction

This patient presented with sudden onset of lateral chest pain aggravated by deep inspiration and coughing.

Listen to this patient’s chest.

Examine her chest.

Salient features

History

• Sharp localized pain worse on coughing or deep respiration

• Nature of the sputum (purulent expectoration in a patient with chest infection, haemoptysis in pulmonary embolism)

• Drug history (oral contraceptives).

Examination

• Pleural rub (superficial, scratchy, grating sound heard on deep inspiration).

Proceed as follows:

• Differentiate between pleural rub and crackles by asking the patient to cough and check whether or not there is any change in the nature (no change with the pleural rub).

• Tell the examiner that you would like to proceed by listening for tachycardia and right ventricular gallop (pulmonary embolism).

Diagnosis

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