Can pleurisy be seen on a chest X-ray?

Written by Shen Jiang Chao
Radiology
Updated on September 14, 2024
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Pleurisy can also be detected in chest radiographs, but it depends on the type. There are two types of pleurisy: dry and wet. Dry pleurisy cannot be clearly identified, while wet pleurisy, which is mostly caused by tuberculosis, can show more typical characteristics. Tuberculous pleurisy primarily manifests as pleural effusion. A small amount of pleural effusion on an X-ray appears as blunting of the costophrenic angle on the same side and blurring of the diaphragm. A moderate amount of pleural effusion is shown on the chest radiograph as a uniformly consistent high-density shadow on the same side, which appears higher on the outside and lower on the inside, with an arc-shaped shadow. The muscle costophrenic angle and diaphragm are obscured. A large amount of pleural effusion presents as a high-density shadow in the pleural cavity on the same side, with the mediastinal cardiac silhouette clearly shifting to the interlateral side.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Common symptoms of pleurisy include chest pain, which often worsens with deep breathing. This condition is also called pleuritic chest pain. It is important to note that the presence of such chest pain does not necessarily indicate pleurisy; it could also be due to pneumonia, pulmonary embolism, or even rib fractures. Patients with pleurisy may also experience a sensation of chest tightness, especially when there is a significant amount of pleural effusion. Furthermore, severe chest pain caused by pleurisy may lead to patients avoiding deep breaths, which can also result in symptoms of chest tightness. Fever is another common symptom in patients with pleurisy, and the severity of fever can vary depending on the infection causing the pleurisy. For example, tuberculous pleurisy, caused by tuberculosis infection, often results in a low-grade fever in the afternoon, but high fevers can also occur. In the case of purulent pleurisy, which is usually due to a bacterial infection leading to pus formation in the pleural cavity, high fevers are common.

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Can you exercise with pleurisy?

Whether or not a patient with pleurisy can exercise should be determined based on the individual's specific condition. For mild pleurisy without pleural effusion and severe pain, exercise is permissible. However, if pleural effusion is present, it should be drained or aspirated first, after which exercise can be encouraged. Exercise should be moderate, as it can help absorb the pleural effusion, which is beneficial for the patient. Additionally, if pleurisy causes severe pain, it is best to minimize movement to avoid exacerbating the pain.

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Written by Wang Chun Mei
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Does pleural calcification easily turn into cancer?

Pleurisy is a very common type of inflammatory lesion clinically. There are many factors that cause pleurisy, and it is generally seen in young and middle-aged males, mainly caused by Mycobacterium tuberculosis infection of the pleural cavity. If the pleurisy is tuberculous, it is usually treated with effective anti-tuberculosis medications systematically, which typically requires a course of 6 to 9 months. After complete recovery from pleurisy, many patients may show varying degrees of calcification spots in the pleural cavity. Generally, these calcification spots after recovery from pleurisy do not easily become cancerous.

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Can pleurisy cause hemoptysis?

Pleurisy, this disease in clinical practice, does not cause symptomatic hemoptysis on its own. This is because pleurisy is mainly due to bacterial invasion into the pleural cavity causing inflammatory lesions. The pleural cavity is a sealed space, which, when inflamed, often causes symptoms such as fever, cough, chest tightness, shortness of breath, and breathing difficulties when there is a significant accumulation of fluid in the chest cavity. Generally, it does not cause hemoptysis. There is only one possibility, for example, intense irritative coughing in patients with pleurisy may rupture the capillaries in the bronchial walls. In this case, patients might experience varying degrees of coughing with blood, but this is not a direct clinical symptom caused by pleurisy itself.

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Is pleurisy calcification dangerous?

Pleural calcification generally poses no major danger. It is typically a result of incomplete treatment of pleuritis or prolonged illness that delays the disease management, causing the disease to progress and the pleura to develop adhesions, leading to the deposition of calcium salts on the pleura and resulting in calcification. Depending on the extent of this pleural calcification, if severe, it may affect lung expansion and thereby reduce respiratory function. However, most cases do not exhibit significant symptoms. Moreover, it does not greatly impact the patient's life or quality of life. Therefore, when such calcification is observed, it is generally recommended that the patient be advised to attend regular follow-up checks. It does not necessarily cause any special symptoms, so there is no need for concern.