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: Inflammation of the pleura due to other diseases, especially Systemic Lupus Erythematosus (SLE, or “Lupus”). 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 ANA blood test. If that’s positive, we do more to prove Lupus, or refer to a rheumatologist.