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Pleurisy and Pleuritis
Pleurisy, often thought of as a disease process, describes a painful condition associated with a number of serious and nonserious diseases. The lining, or pleura of the lung, can become inflamed, resulting in a condition known as pleuritis. The chest pain of pleuritis is known as pleurisy. The chest pain of pleurisy is most often described as "sharp" or "knife-like", and increases in severity as the patient breathes in. Pleurisy is often one-sided and can radiate pain to the neck or shoulder. Movement of the thorax, including bending, stooping, or even turning in bed can increase pleural pain. When pleurisy is associated with shortness of breath, a more serious disease process is a possibility. Pleurisy can easily confused with chest wall pain which is much less serious. Chest wall pain can sometimes be distinguished from pleurisy by pressing down (palpation) on a region of the chest wall which will reproduce pain in the patient.
SOME CAUSES OF PLEURISY
1. Pneumonia (viral or bacterial)
2. Pulmonary Embolism
3. Pneumothorax
4. Lung cancer
5. Rheumatic diseases (e.g. rheumatoid arthritis, lupus)
6. Tuberculosis
Evaluation of pleurisy often includes a chest x-ray to omit the possibility of pneumothorax or pneumonia. In some selected cases, the patient's history and physical examination may be all that is necessary. Those complaining of shortness of breath may require arterial blood gas analysis. Some cases may require an EKG to exclude the possibility of angina (angina pain in rare cases can be pleuritic in nature). Ventilation/perfusion scanning of the lung is performed in cases of suspected pulmonary embolism. Treatment will be directed to the underlying cause. Narcotic analgesics may be necessary when pain is severe. Anti-inflammatory agents (ibuprofen) can also be helpful. See your physician IMMEDIATELY for evaluation of any chest pain that is pleuritic in nature.
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