Diagnosis of Pleural Effusion

The diagnosis of pleural effusion is usually performed in a clinical setting. The doctor will ask you to undergo a physical examination in which they will listen to the sound of your breathing using a stethoscope. The doctor often also taps on your shoulders to listen whether the sound is dull or hollow. In addition to the preliminary physical test, there are some additional diagnostic tests for pleural effusion such as:  

  • Chest CT Scan: This is a test in which cross sectional X-rays are taken to check for any abnormalities in the chest cavity and the upper abdomen. This is a simple test which can help the doctor ascertain if you have any chest infections or abnormalities in the upper and lower respiratory tract.
  • Chest X Ray: This simple X-ray can show presence of cloudiness and fluids in the chest cavity. This is usually the first test prescribed by the doctor.
  • Pleural Fluid Analysis: In this test, a sample from the pleural cavity is obtained and checked for presence of bacteria under the microscope. The doctors are also able to look for abnormal amounts or proteins or cancer markers and cancer cells in the fluid.
  • Thoracentesis: This is a test in which a needle is inserted into the chest cavity, between the ribs and a small amount of the fluid is taken for analysis. This test is much like pleural fluid analysis.
  • Ultrasound of the Chest: This is a simple ultrasound test in which sound waves are used to check for blockages and fluids in the chest cavity and the lungs.
Doctors usually use less invasive tests for the diagnosis of pleural effusion, however if the condition remains undiagnosed despite all the tests, the doctors may have no other choice than to use thorascopy. This is an invasive technique in which a small surgery is performed in the thoracic cavity using a scope that has a small light bulb and a video camera at one end. This technique is also often called video-assisted thoracoscopic surgery and is performed under general anesthesia. This diagnostic method can often also be used for treatment of pleural effusion. 
Frequently asked questions
  1. R.W. Light, Y.C.G. Lee, PLEURAL EFFUSIONS | Overview, In:   Geoffrey J. Laurent and Steven D. Shapiro, Editor(s)-in-Chief, Encyclopedia of Respiratory Medicine, Academic Press, Oxford, 2006, Pages 353-358, ISBN 9780123708793, 10.1016/B0-12-370879-6/00299-4.
  2. Jeffrey S. Pollak, Catherine M. Burdge, Melvin Rosenblatt, Jeffrey P. Houston, Wen-Jen Hwu, John Murren, Treatment of Malignant Pleural Effusions with Tunneled Long-term Drainage Catheters, Journal of Vascular and Interventional Radiology, Volume 12, Issue 2, February 2001, Pages 201-208, ISSN 1051-0443, 10.1016/S1051-0443(07)61826-0.