Evaluation of pleuritis

Images

Evaluation of pleuritis

CT scan showing large right pleural effusion

From the collection of Dr Nicholas Maskell; used with permission

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• Diagnosis Approach

Evaluation of pleuritis

CT scan showing loculated pleural effusion

From the collection of Dr Ami Rubinowitz; used with permission

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• Diagnosis Approach

Evaluation of pleuritis

Large left pneumothorax with visible pleural line and absence of lung markings beyond the line

From the collection of Dr Ami Rubinowitz; used with permission

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• Etiology
• Urgent considerations
• Differentials

Evaluation of pleuritis

Modified Wells criteria (score ≤4: PE unlikely; score >4: PE likely)

From Wells PS, Anderson DR, Rodger M, et al. Thromb Haemost. 2000;83:416. Used with permission

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• Diagnosis Approach

Evaluation of pleuritis

CT scan of chest showing empyema necessitans (long arrow), a chronic untreated empyema that has eroded through the thoracic cage and formed a subcutaneous abscess (short arrow)

From the collection of Dr Ami Rubinowitz; used with permission

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• Diagnosis Approach
• Differentials

Evaluation of pleuritis

CT scan showing metastatic malignancy of pleura

From the collection of Dr Ami Rubinowitz; used with permission

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• Diagnosis Approach
• Differentials

Evaluation of pleuritis

CXR showing large right pleural effusion

From the collection of Dr Kathryn Bateman; used with permission

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• Diagnosis Approach
• Differentials

Evaluation of pleuritis

Thoracic ultrasound image of large, simple pleural effusion

From the collection of Dr Nicholas Maskell; used with permission

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• Diagnosis Approach
• Differentials

Evaluation of pleuritis

Schematic showing a summary of the diagnostic approach (CXR=chest x-ray, PE-pulmonary embolism, EKG=electrocardiogram)

Courtesy of Dr Ami Rubinowitz; used with permission. Updated November 2023 by BMJ Best Practice Editorial Team

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• Diagnosis Approach

Evaluation of pleuritis

PA and lateral CXR showing calcified pleural plaques

From the collection of Dr Ami Rubinowitz; used with permission

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• Diagnosis Approach

Evaluation of pleuritis

CT scan showing empyema with split pleura sign (enhancement of the thickened inner visceral and outer parietal pleura separated by a collection of pleural fluid)

From the collection of Dr Ami Rubinowitz; used with permission

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• Diagnosis Approach

Evaluation of pleuritis

CT scan showing circumferential right-sided pleural thickening with significant volume loss due to mesothelioma

From the collection of Dr Nicholas Maskell; used with permission

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• Diagnosis Approach
• Differentials

Videos

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  Needle decompression of tension pneumothorax: animated demonstration

  How to decompress a tension pneumothorax. Demonstrates insertion of a large-bore intravenous catheter into the fourth intercostal space in an adult.

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  Insertion of intercostal drain, open technique: animated demonstration

  How to insert an intercostal (chest) drain using the open technique. Video demonstrates: tube selection, how to identify the site for drain insertion, how to make the correct incision, how to insert the intercostal drain, how to secure the drain, and postprocedure care.

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  Insertion of intercostal drain, Seldinger technique: animated demonstration

  How to insert an intercostal (chest) drain using the Seldinger technique. Video demonstrates: how to identify a safe site for insertion; use of an introducer needle, guidewire, dilators, and intercostal drain; how to confirm drain position; and postprocedure care.