Pleural Disorders Diagnosis

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Your healthcare provider will want to learn about your symptoms and risk factors and do diagnostic tests or procedures to determine whether you have a pleural disorder and, if so, what type.

To help diagnose a pleural disorder, your healthcare provider may ask you about your personal and family health history. They will also 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 provider determine whether it is caused by problems with your heart, chest muscles, lungs, or digestive system.

As part of a physical examination, your provider 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. They may also check the level of oxygen in your blood with a probe on your finger or forehead.

Your provider 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 provider may hear a dull sound when they tap on your chest.
• If you have a pneumothorax, your provider may hear more echo than usual when they tap on your chest.

Your provider may order a combination of the following tests to help diagnose a pleural disorder. These tests may also help  rule out other medical conditions that can cause chest pain.

• Biopsies take a sample of the pleura. The sample is checked for signs of disease.
• Blood tests show whether you have an illness that increases your risk of pleurisy or another pleural disorder
• Lung imaging tests such as a chest MRI or chest X-ray look for fluid or air in the pleural space or other possible causes of pleural disorders, such as pneumonia, a fractured rib, or a lung tumor.
• Endoscopies look for signs of disease, guide the doctor while performing a biopsy, or remove pleural fluid.
• Thoracentesis procedure removes 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.
• Ultrasounds look for fluid, air, or other abnormal findings in your chest.