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Old 11-04-2002, 09:17 PM   #1
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Post Pleural Friction Rub

I recently went to my Dr. for a routine check-up. He heard a 'sound' in my back when I took deep breaths. He wasn't sure what it was so he referred me on to a pulmonary specialist. I had a chest x-ray and a CT scan of my chest. Everything came back normal so the pulmonary specialist said it is a pleural friction rub and was caused by a virus. He said it should eventually go away. Well, here it is 6 months later and I still have it. The specialist is stumped. He's never had one not go away before. He put me on an anti-inflammatory and the 'rub' sound gets softer but then when I go off the anti-inflammatory it gets loud again. Anyone else deal with this? He did say I could be in the very early stages of an autoimmune disorder but all of those test come back normal too.

 
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Old 11-05-2002, 08:57 AM   #2
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Have you had a bronchoscopy (sp?) or an open lung biopsy? This is the only way to diagnose certain respritory diseases. If you have had no improvment after 6 months I would reccomend requestion one of these tests

 
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Old 11-05-2002, 08:58 PM   #3
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a bronchoscopy won't diagnose a problem with the pleural membrane because a bronchoscopy examines the inside of the lungs and a pleral friction rub is located outside of the lung. Dig?

If you don't feel any pain, I wouldn't think it'd be anything to worry about -- esp. if cxr comes back normal. I'm not sure exactly why doctor is so worried about it, probably just BECAUSE it has taken forever to go away.

 
Old 11-06-2002, 06:21 AM   #4
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wrin, thanks for your reply. The pulmonary specialist did say that since I am very thin that is why we may still hear it. He just said he's never had a patient with a rub that didn't eventually go away. On occasion I'll get a sharp stabbing pain and he said when that occurs to take the anti-inflammatory. He said we'll just treat the symptoms, i.e. any pain I may experience, since chest x-rays and chest CT scan have come back normal. Overall it doesn't cause me any problems, just the thought of knowing it's there and not going away is what is weighing on my mind.

 
Old 11-06-2002, 09:58 AM   #5
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Yeah, sounds like it kind of sucks -- doesn't sound like an infection or a total inflammation, though, so you're better off than some. I can't imagine living with Pleurisy where an entire side or even the whole lung field is inflamed, it'd be like having broken ribs all over the place.

It is very easy to hear a pleural rub in someone for whom it does not cause a lot of pain -- there are actually two ends to the pleura, the visceral pleura (That wraps the lungs) and the parietal pleura (that wraps the body cavity inside.) Between these is where the rub would be heard -- and only the parietal pleura has pain receptors. This means that if there is inflammation in the visceral pleura and your doctor can hear the rub, chances are you won't feel it, so it is important to note whether the pain happens more often or begins to become constant, or if you feel it in another area of your lungs, because this could mean that the inflammation is spreading and you should be on something a little more intensive therapy-wise.

Chances are that it will go away -- it's very easy to hear pleural rub on people for whom it causes no pain, because they can take the deep breaths required to hear the sound properly. It sounds like creaking leather, and for people who are splinting (breathing shallowly and quickly) because of pain, it's easy to mistake this creaking for coarse crackles from secretions and mis-diagnose.

 
Old 11-06-2002, 01:10 PM   #6
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wrin, thanks again for your reply. You sound very knowledgable on this subject matter. May I ask how you came to be so? I'm hoping it will eventually go away. Like I mentioned before it's more of a 'head trip' knowing that I've got this funny sound that hasn't gone away. I don't like that! My Dr. just looked at me and said, 'you've got a weird body.' Jokingly of course!

 
Old 11-06-2002, 04:30 PM   #7
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Taking respiratory therapy in college ... very intensive three-year diploma program. Enjoying it quite thoroughly.

Yeah, if I were your Dr. I wouldn't know what to make of it either... I'd be tempted to leave well enough alone though. LOL ... be like, "It's not causing you any problems, I can't see anything outwardly wrong... perhaps we should leave it do its own thing..."

 
Old 11-06-2002, 10:13 PM   #8
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wrin,So what will your job be once your finish your program? That's great that you come here and try to help out others who have questions in this area. I really like the pulmonary specialist that my Dr. sent me too. He was totally trying to reassure me but then in the next sentence told me that all the rubs he's ever seen have always gone away. Why do I have to be the odd one? LOL My regular Dr. thought it would go away too. He described to me that it would scar over, relubricate and the sound would go away. Does that make sense to you? The pulmonary specialist also said that because I am so thin that could be why we still hear it. I don't know if I buy that or not. He said others with lots of 'flubber' might have one that he'd never hear in the first place.

 
Old 11-07-2002, 06:10 PM   #9
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Your pulmonary specialist is right -- it's much easier to hear any kind of breath sound in those who are thinner as there's less ... insulation ... so to speak.

The pleural rub thing, yes, it'll likely go away, and going away doesn't have to mean six months, either. You could have it and he could hear it on your next yearly checkup, and you might even forget about it, and it might go away even after that. "Go away" doesn't mean right this minute sucks, I know..

My job will be a respiratory therapist. I will be doing a multitude of tasks, from taking care of the sickest of the sickest critical care patients all the way down to pulmonary function testing, hyperbaric oxygen, and assisting with bronchoscopy.

 
Old 11-08-2002, 05:34 PM   #10
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Thanks for the added reassurance. I didn't realize it could take awhile for it to go away. That's good to know.

The pulmonary specialist did say that he saw small calcifications (sp) on my x-ray. He said, 'don't worry, I have them too.' What in the world is that? I've never smoked or been exposed to any pollutants that I know of.

 
Old 09-17-2003, 07:10 AM   #11
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I have been told that I have pleural rub also. Mine is due to recurrent pulmonary embolisms. I urge you, if it hasnt been done already, to request a vq san. tis is the only accurate way of diagnosing pulmonary embolisms. Peural rub is a fairly classic symptom. If you have pe's you need to find out as they are life threatening

 
Old 09-17-2003, 07:13 AM   #12
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sorry about all those typos, I meant a vq scan!

 
Old 09-22-2003, 02:50 PM   #13
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Hi, I have had pain under my ribs for the past 6 months, it has now gone down both side of my back. Pain on right side is worst when I have been bending over cleaing for hours, which I do as my job. 2 Doctors I went to told me it was mascular which I didn't beleive. I went to a new doctor yesterday and she sent me for a chest X-ray but she did mentioned she could hear the pleural rub thing. What causes this and did anyone else hjave these sort of pains. Also my gallbladder is not functioning properly.

 
Old 09-25-2003, 04:08 PM   #14
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I have had pleurisy on and off for a couple of months or so, but mine is painful (I am also thin so it is easy for me to hear with my stethoscope, sounds like leather rubbing together).

I also have Rheumatoid Arthritis which is an autoimmune disease, and it is frequently a problem for those with immune problems. I am not looking forward to a life of repeated episodes of pleurisy, so I hope this is a one time deal.

Anyway, you can have an auto immune disease and it not show up in your blood tests. Try to do some research on it and see if anything sounds familiar (Lupus or Rheumatoid Arthritis). But don't get freaked out, there is a lot of information out there that seems very scary, but it really doesn't have to be that bad.

Good luck

 
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