Pleural inflammation CT manifestations

Written by Shen Jiang Chao
Radiology
Updated on September 19, 2024
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The causes of pleurisy mainly include tuberculous, purulent, bacterial, tumorous, traumatic, and rheumatic types, with the tuberculous type being the most common. Pleurisy is predominantly characterized by pleural effusion, which generally looks similar on a CT scan. CT scans cannot distinguish the cause of pleurisy. A small amount of pleurisy manifests as a minor amount of free effusion, appearing as an arc or crescent of uniform density along the posterior chest wall. As the effusion gradually increases to a moderate or large amount, it can compress lung tissue, leading to compressive atelectasis. In cases of large volume effusion, aside from causing atelectasis, it can also significantly push the mediastinum towards the healthy side.

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Written by Wang Chun Mei
Pulmonology
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Is it normal to occasionally feel chest tightness with pleuritis?

Patients with pleurisy occasionally experience chest tightness, which is a very common clinical symptom. It is important to clarify that in clinical cases, pleurisy is mostly due to infection of the pleural cavity by Mycobacterium tuberculosis, causing clinical symptoms such as fever, chest tightness, shortness of breath, cough, and chest pain. Therefore, during an acute episode of pleurisy, some patients may have a severe pleural infection, and possibly a large amount of pleural effusion, which inevitably leads to symptoms like shortness of breath and chest tightness. For patients with pleurisy, if it is tuberculous, it is crucial to provide anti-tuberculosis medication as early as possible for symptomatic treatment. A lengthy course of treatment is usually required to effectively control the discomfort caused by pleurisy.

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Written by Wang Chun Mei
Pulmonology
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Is it normal to occasionally have chest pain with pleurisy?

Pleurisy is a very common type of disease, with many triggering factors. Most cases of pleurisy are caused by infection of the pleural cavity by Mycobacterium tuberculosis, leading to inflammatory lesions. Once pleurisy is diagnosed, patients should promptly receive anti-tuberculosis medication for effective treatment. It is commonly known that if pleurisy is not controlled promptly and effectively, it may lead to worsening symptoms such as cough, fever, shortness of breath, chest tightness, and chest pain, so these clinical symptoms are also very common in patients with pleurisy. Therefore, it is very common for patients with pleurisy to experience chest pain. Even after complete recovery from pleurisy, there may be varying degrees of chest pain, which is considered normal. This is because pleurisy in the acute phase may involve different degrees of adhesions, hence chest pain may occur later on as well.

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Written by Wang Chun Mei
Pulmonology
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What causes pleurisy in young people?

In clinical practice, populations with pleurisy are often common among young people and children. The factors inducing pleurisy in young people are mainly due to low immune function and the presence of pathogenic factors that stimulate an inflammatory response in the pleura. Such patients often experience infections, with tuberculosis infections being more common. This often leads to clinical symptoms such as chest pain, chest tightness, shortness of breath, coughing, wheezing, and even difficulty breathing. Therefore, for individuals with low immune function, it is particularly important to pay attention to strengthening nutrition and to balance work and rest. When the body's functions are weakened, it is necessary to properly enhance nutrition and exercise to improve the body's immunity and reduce the likelihood of developing pleurisy.

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Written by Wang Chun Mei
Pulmonology
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Is it normal to have pain in the later stages of pleurisy?

Pleurisy is very common in clinical settings, caused by various pathogens invading the pleural cavity, leading to an inflammatory response. Most pleurisy patients are mainly afflicted due to infections by the tuberculosis bacillus, thus pleurisy typically comes with varying degrees of effusion, leading to different degrees of adhesion in the pleural cavity. Therefore, even during the acute phase of pleurisy, patients may suffer from symptoms such as coughing, fever, chest pain, breathlessness, and difficulty breathing. Even after effective medicinal treatment of pleurisy and full recovery, patients may still experience varying degrees of chest pain later on, primarily due to various degrees of pleural adhesion. During physical exertion or coughing, this can lead to varying degrees of chest pain, a very common occurrence.

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Written by Luo Peng
Thoracic Surgery
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What medicine to take for pleurisy

Regarding what medicine to take for pleurisy, it depends on the specific actual situation. If it is simple mild pleuritis without pleural effusion and only pain, generally, if the pain is not severe, medication may not be necessary. If the pain is severe, one can (under the guidance of a doctor) take oral pain relievers like ibuprofen or acetaminophen with codeine for symptomatic treatment. If there are symptoms such as fever, coughing up phlegm, pleural effusion, or even suspected tuberculous pleuritis, long-term oral anti-tuberculosis drugs are required for treatment. If tuberculosis cannot be confirmed and there are no significant symptoms, symptomatic treatment can be administered temporarily.