Pleurisy / Pleuritis

Pleurisy is [presumably] viral, and a diagnosis of exclusion.  There’s no dyspnea, except to the extent that pain with breathing may limit exertion.  A patient has new pleuritic chest pain which hurts with breathing or coughing but not other movements (i.e. doesn’t seem musculoskeletal), physical exam and chest x-ray are normal.  Self-limiting.

Pleuritis may accompany collagen-vascular disorders, particularly Lupus (SLE).  Ask about prior episodes.  Inquire about other symptoms of SLE, like malar rash, other rashes, arthralgias, aphthous ulcers, alopecia areata.  If in doubt, order an ANA.

See Chest Pain – 2.