Inflammation of the pleura without an effusion results in localized sharp pain made worse on deep inspiration, coughing and bending or twisting movements. Common causes are pneumonia, pulmonary infarct and carcinoma. Epidermic myalgia (Bornholm disease) is due to infection with Coxsackie B virus. It is characterized by an upper respiratory tract infection followed by pleuritic pain and abdominal pain with tender muscles. The chest X-ray remains normal and the illness clears in 1 week.
The major complication of Pleurisy is effusion and most a times, manifestations on Chest X-ray show effusion.
Pleurisy And Its Complication (Effusion) On Chest X-ray
Pleurisy (also known as pleuritis) is an inflammation of the pleura, the lining surrounding the lungs. There are many possible causes of pleurisy but viral infections spreading from the lungs to pleural cavity are the most common. | Source
The inflamed pleural layers rub against each other every time the lungs expand to breathe in air. This can cause sharp pain when breathing, also called pleuritic chest pain. | Source
The defining symptom of pleurisy is a sudden sharp, stabbing, burning or dull pain in the right or left side of the chest during breathing, especially when one inhales and exhales | Source
It feels worse with deep breathing, coughing, sneezing, or laughing. The pain may stay in one place, or it may spread to the shoulder or back. | Source
Pleural space can be invaded by fluid, air, and particles from different parts of the body which fairly complicates the diagnosis. Viral infection (coxsackievirus, RSV, CMV, adenovirus, EBV, parainfluenza, influenza) is the most common cause o | Source
However, many other different conditions can cause pleuritic chest pain | Source
When the space between two layers of pleura starts to fill with fluid in a case of pleural effusion, it can ease the chest pain, but instead creates a shortness of breath, since the lungs need room to expand during breathing. | Source
Some cases of pleuritic chest pain are idiopathic, which means that the exact cause cannot be determined. | Source
A diagnosis of pleurisy or another pleural condition is based on a medical history, physical examinations, and diagnostic tests | Source
The goals are to rule out other sources of the symptoms and to find the cause of the pleurisy so that the underlying disorder can be treated. | Source
A doctor uses a stethoscope to listen to the breathing. This method detects any unusual sounds in the lungs. A person with pleurisy may have inflamed layers of the pleura that make a rough, scratchy sound as they rub against each other during breathi | Source
A chest x-ray takes a picture of the heart and lungs. It may show air or fluid in the pleural space. It also may show the cause (e.g. pneumonia, a fractured rib, or a lung tumor) of the pleurisy. | Source
Sometimes an x-ray is taken while lying on the painful side. This may show fluid, as well as changes in fluid position, that did not appear in the vertical x-ray. | Source
Once the presence of an excess fluid in the pleural cavity, or pleural effusion, is suspected and location of fluid is confirmed, a sample of fluid can be removed for testing | Source
The procedure to remove fluid in the chest is called a diagnostic thoracentesis. The doctor inserts a small needle or a thin, hollow, plastic tube in the chest wall and withdraws fluid. | Source
Thoracentesis can be done in the doctor's office or at the hospital. Ultrasound is used to guide the needle to the fluid that is trapped in small pockets around the lungs. | Source
Thoracentesis usually does not cause serious complications. Generally, a chest x-ray is done after the procedure to evaluate the lungs. | Source
The lung fluid is examined under a microscope and is evaluated for the presence of chemicals and for its color and texture. The degree of clarity is an indicator of infection, cancer, or other conditions that may be causing the buildup of fluid or bl | Source
Sometimes air comes in through the needle or the needle makes a hole in the lung. Usually, a hole will seal itself. But sometimes air can build up around the lung and make it collapse. | Source
1. All X-ray photos here are from DFM E-Group, in the photo and X-ray section.
2. Notes and explanations: Wikipedia, Essentials of Clinical Medicine by Kumar and Clark's, Medicinenet and Mayor's Clinic.