Pleurisy is often used by medical professionals and laypeople both to refer to the inflammation of the pleura and also the symptoms. Strictly we should reserve pleurisy for the name of the condition, whilst using pleuritic pain for the symptom.
Pleurisy typically presents as pleuritic pain, which is typically described as being sharp in nature. Classically pleuritic pain is exacerbated by any action involving a vigorous inspiration/expiration, e.g. sneezing, laughing, coughing, and deep breathing. Chest wall tenderness may be present. Occasionally a pleural rub can be heard.
Other signs and symptoms will depend on the underlying etiology.
This is a list of etiologies of pleurisy, not for pleuritic pain, which would be different.
- exogenous agents
- inflammatory: rheumatoid arthritis, lupus pleuritis, Sjogren syndrome
- cardiac: Dressler syndrome
- gastrointestinal: inflammatory bowel disease, spontaneous bacterial pleuritis
- familial Mediterranean fever
- renal: chronic renal failure
Clearly, in any patient presenting with acute pleuritic pain, it is crucial to exclude the top three diagnoses here.
- 1. Kass SM, Williams PM, Reamy BV. Pleurisy. (2007) American family physician. 75 (9): 1357-64. Pubmed