Pleural Friction Rub-Lung Sound Collection

Pleural friction rub is an abnormal lung sound which is caused by inflammation of the pleural layer of the lungs rubbing together. Pleural friction rub is heard on inspiration and expiration and sounds like a low-pitch harsh/grating noise. Pleural friction rubs may sound similar to pericardial friction rubs. However, to tell the difference when listening to a patient, have the patient hold their breath and if the sound disappears it is not a pleural friction rub but a possible pericardial friction rub.
pleural friction rub vs coarse crackles, pleural friction rub vs pericardial friction rub, pleural friction rub causes, pleural friction rub medzcool, pleural friction rub sound like, pleural friction rub vs rhonchi, pleural friction rub chest tube,เสียง pleural friction rub, pleural friction rub audio, breath sounds pleural friction rub, what does pleural friction rub sound like, lung sounds pleural friction rub, pericardial friction rub vs pleural friction rub, lung sounds pleural rub, pleural friction rub sounds, sound of pleural friction rub, pleural friction rub sounds in the lungs, pleural friction rub without pain, pleural friction rub lung sound, friction rub lung soundA pleural friction rub is an adventitious breath sound heard on auscultation of the lung. The pleural rub sound results from the movement of inflamed and roughened pleural surfaces against one another during movement of the chest wall.[1] This sound is non-musical and described as “grating,” “creaky,” or “the sound made by walking on fresh snow.”[2] It is often heard in the upper lung fields. Any potential cause of pleural effusion, pleuritis, or serositis can result in a pleural friction rub. Patients may be able to describe the localization of the rub based on pain. A pleural friction rub is a manifestation of pleural disease, though its absence does not exclude this pathology. The finding of a pleural friction rub requires prompt recognition and action on the part of the physician. Auscultation of a pleural friction rub can occur when the normally smooth surfaces of the visceral and parietal pleura become roughened by inflammation.[1] Pleurisy, as well as other conditions affecting the chest cavity, can cause a pleural friction rub. A pleural friction rub is a common finding in patients with pneumonia, pulmonary embolism, malignant pleural disease, and pleurisy secondary to viral infection or pancreatitis, among other causes.[3]

Pleural friction rubs need to be distinguished from pericardial friction rubs, which is a sign of pericarditis. Pleural friction rub occurs when inflammation roughens the surfaces of the visceral and parietal pleura. In this setting, friction between the pleura further increases due to decreased production of lubricating fluid (pleural fluid) by the pleura.[4] The characteristic grating sound of the pleural rub is believed to result from the release of energy when the inflamed pleural surfaces overcome the increased friction and slide past one another.[4] Often, pleural friction rub is accompanied by pleuritic chest pain, which is characterized by sudden, intense, and sharp pain that is worse with inspiration.[3] If the site of inflammation is near the diaphragm, pain can refer to the neck or shoulder.[3] While the visceral pleura lacks somatic innervation and nociceptors, somatic nerves innervating the parietal pleura relay the sensation of pain.[3] Somatic nerves innervating the parietal pleura are responsible for this pattern of pain. The visceral pleura lacks somatic innervation and nociceptors. Patients will often complain of pleuritic chest pain, which is sudden, intense, and worse with movement, such as respiration. If the underlying cause of the pleural rub is pleural effusion, patients may experience some relief from leaning forward and supporting their upper body with hands placed on the knees or another surface.
Upon palpation of the chest, the clinician may note a sandpaper-rubbing type of sensation. This sensation is suggestive of a pleural rub. The patient may complain of local tenderness with palpation, depending on the underlying etiology.[3]
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