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Pleural Effusions: Diagnostic Considerations

The presence of fluid in the pleural space can be seen in a variety of disorders. Presenting symptoms include dyspnea, pleuritic chest pain, and ipsilateral shoulder pain if pleural involvement occurs at the central portion of the diaphragm. Physical examination findings include chest asymmetry, diminished breath sounds, dullness to percussion, and decreased tactile fremitus. In an upright patient, the radiographic appearance of pleural fluid includes blunting of the costophrenic angle, straightening or a more lateral peak of the hemidiaphragm contour, simulation of an elevated hemidiaphragm, or a distance of greater than 2 cm between the gastric air bubble and the lung.

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				G. L. Kohn and W. D. Hardie Measuring Pleural Fluid pH : High Correlation of a Handheld Unit to a Traditional Tabletop Blood Gas Analyzer Chest, December 1, 2000; 118(6): 1626 - 1629. [Abstract] [Full Text] [PDF]