Pleural Rub

MANUAL OF CLINICAL DIAGNOSIS

A pleural rub is an abnormal sound heard during chest auscultation, produced when inflamed pleural surfaces rub against each other during respiration. This sound is similar to the creaking of two pieces of leather being rubbed together and is typically more audible during both inspiration and expiration. The presence of a pleural rub indicates inflammation or irritation of the pleura, the membrane that covers the lungs and lines the chest cavity.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Pneumonia with Pleurisy	Fever, productive cough, pleuritic chest pain, dyspnoea, pleural rub	Medical history of respiratory infection, physical examination	Chest X-ray, computed tomography (CT), sputum culture
Pulmonary Embolism	Sudden dyspnoea, pleuritic chest pain, haemoptysis, tachycardia, pleural rub	Medical history of risk factors, physical examination	Pulmonary angiography, contrast-enhanced CT, D-dimer test
Pulmonary Infarction	Pleuritic chest pain, dyspnoea, haemoptysis, fever, pleural rub	Medical history, physical examination, history of thromboembolism	Chest CT, lung scintigraphy, echocardiogram
Severe Secondary Pleural Thickening	Chest pain, dyspnoea, decreased breath sounds, pleural rub	Medical history of previous pleural diseases, physical examination	Chest X-ray, chest CT, pleural biopsy