[Can pleurisy be detected with ultrasound?].

PURPOSE: It was the aim of this study to examine whether chest sonography is a useful method for diagnosing infective pleuritis. We assessed the pleural surface, the presence of subpleural consolidations and of pleural effusions.

METHOD: 47 consecutive patients with the clinical diagnosis of pleuritis were examined by means of a 7 MHz linear transducer. We studied the pleural surface, the presence of subpleural consolidations and of pleural effusions.

RESULTS

Pathologic findings could be seen in 43 patients (91%). The smooth echogenic pleural line was interrupted and was rough in appearance in 42 patients (89%). Subpleural consolidations from 0.2 to 2 cm in size were observed in 30 cases (63.8%). In 11 (23.4%) of these lesions, colour Doppler signals could be demonstrated. Pleural effusions were visible either as localised pleural effusions (24 patients, 51%) or as basal effusions (11 cases, 23.4%). Aspiration of pleural fluid was performed twice. In one case the diagnosis of tuberculosis could be proven by fast acid stain, in another patient a pleural empyema was drained successfully under ultrasound guidance. In 5 patients therapeutic consequences resulted from sonographic findings.

CONCLUSION

We conclude that chest sonography is a sensitive and cost effective imaging method for the diagnosis of pleuritis. Aspiration of pleural fluid for further diagnostic or therapeutic procedures can be safely performed.