Reduced Vocal Fremitus

MANUAL OF CLINICAL DIAGNOSIS

Reduced vocal fremitus refers to the decrease in vocal vibrations felt through the chest wall when the patient speaks. These vibrations are typically transmitted from the vocal cords through the lungs and pleura.

A reduction in vocal fremitus may indicate the presence of an underlying pathology that affects the transmission of these vibrations, such as the accumulation of fluid or air in the pleural cavity, or the collapse of a part of the lung.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Pleural Effusion	Dyspnoea, chest pain, dull percussion, decreased breath sounds	Medical history, physical examination, reduced vocal fremitus	Chest X-ray, thoracic ultrasound, chest computed tomography (CT)
Pneumothorax	Dyspnoea, chest pain, decreased or absent breath sounds on the affected side	Medical history, physical examination, reduced vocal fremitus	Chest X-ray, chest CT
Collapsed Lung Lobe without Consolidation	Dyspnoea, cough, decreased breath sounds in the affected area	Medical history, physical examination, reduced vocal fremitus	Chest X-ray, chest CT