Pleurisy / Pleuritis

Pleurisy is a poorly-defined irritation of the outside linings of the lung (the pleura), presumably caused by a virus.  It goes away on its own; treatment is simple pain medicines.  It may be impossible to distinguish from a Muscle Strain, but both are treated the same & neither is dangerous.

We diagnose it if there’s only acute pleuritic chest pain (pain with each breath or cough), and nothing else:

  • no shortness of breath with exertion
  • normal physical exam, and
  • normal CXR (if we get one, which we usually don’t)

The only other things to consider:

Pleuritis:ย  Inflammation of the pleura due to other diseases, especially Systemic Lupus Erythematosus (SLE, or โ€œLupusโ€).ย  So we ask about other Lupus symptoms, now or past:

  • joint pains (especially hands, especially in the morning)
  • cheekbone rash
  • other unusual rashes
  • fingers turn actual colors (red, white, blue) especially in cold
  • spotty hair loss
  • mouth ulcers

If these symptoms are suggestive, we order an antinuclear antibody (ANA) blood test.ย  If that’s positive, we do more to prove Lupus, or refer to a rheumatologist.

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