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Old 04-03-2003, 03:23 PM   #1
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Post pleural friction rub???

About a year ago my dr. heard a sound in my back when I would take deep breaths. He didn't know what it was so he ordered a chest x-ray and a chest cat scan. Everything came back normal. He was baffled so sent me to a pulmonary specialist. The specialist said I have a pleural friction rub and that there is nothing wrong with my lungs. He did say that he's a little baffled by the fact that the rub hasn't gone away. Since seeing the specialist I've seen two other dr.'s, one was my OB/GYN for my annual check-up and the other was a new dr. I had to see for a get acquainted visit because we changed insurances and had to change dr's. I didn't tell either of those Dr's about the pleural friction rub. They both heard it when listening to my back. And both of them said they didn't think it was a rub. They both said it sounded like something vascular because they hear a noise and then a pause and then a noise again. So now I'm worried all over again. I was pretty much reassured by the specialist that it was a rub and now I've had two other Dr's tell me it doesn't sound like that to them. Granted the specialist is considered the 'expert' when it comes to the lungs but when two other dr's tell you something different you start to wonder. Does anyone know if pleural friction rubs can sound like mine? Thanks!

 
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Old 04-03-2003, 07:20 PM   #2
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Rubs are so hard to diagnose. Really.

It would only be something vascular if it was timed with your heart and not your breathing. If you took a breath and the rub sounds exactly the same from breath-to-breath (this is usually how you can distinguish a rub from crackles) then it's probably a rub.

You might have another kind of rub, like a pericardial rub. I don't even know if these exist, but I imagine they could. It probably isn't anything serious.

 
Old 04-03-2003, 09:07 PM   #3
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The pulmonary specialist said it's not a pericardal (sp) rub and explained why of which I don't remember the explanation. So what the heck is it? I'm starting to think I'm some kind of 'freak' walking around with this sound in my back. I've 'talked' to you about this before wrin. I'm glad you answered my post. I thought I was satisfied with the specialists explanation until I have someone listen to it and they disagree with him. Didn't you tell me once before that sometimes a rub won't go away and will always be heard? The specialist did say that because I am so thin it is easier to hear on me. Why doesn't the rub cause pain?

 
Old 04-05-2003, 02:00 AM   #4
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The rub might not cause pain because it isn't rubbing on a part of your pleura that's hideously packed with pain receptors. A good thing to know is that your visceral pleura (the stuff wrapping your lungs) has no pain receptors, whereas your parietal pleura (or the stuff that lines your ribcage,) does. So if your parietal pleura isn't getting rubbed on, or the rub isn't very big, it probably won't cause pain.

Yes, a rub might stay for-ever-and-ever. Some things might even CAUSE a rub. I have a friend who had a rather nasty pleural effusion after surgery for a burst appendix, and had to have a chest tube inserted. She now has a very distinct pleural friction rub over her right lower lobe, posteriorly. It's just scarring that's happened on the pleura that's touching. It doesn't cause her any pain, but it sounds MOST interesting with a stethoscope. Sounds like crackles, but you can tell they're not because it makes the exact same pattern of creaking no matter how she inhales, and exhales. Creak-creakcreak, creak. Creak. Creakcreak.

The thinner you are the less bone and fat and tissue that can distort the sound. Kind of like listening to someone speak through a thin wall as opposed to a thick wall. Ne?

Maybe the rub didn't match to your heart rate, like a pericardial rub would? I don't know. But like I said before -- rubs are deceptive -- they can sound like a lot of things.

 
Old 04-05-2003, 09:19 AM   #5
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Thanks again wrin. I wish you could stick your stethescope (sp) through the computer and take a listen! LOL So are you saying, by your creak, creak, description of a rub that a rub can make a sound, pause and then make a sound, like mine does. That's why so many dr's have said its a blood flow or vascular 'thing.' Here's a list of docs that don't think it's a rub, my OB/GYN, my internist and our family dr. Here's who thinks it is a rub, a pulmonary specialist. Who would you go with? LOL No one ever heard it until I had a nasty respitory virus in December of 2001. Could that cause a rub?

 
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