Pleuritic Chest Pain Differentials

Question 1

What is this describing?

“Sudden and intense sharp, stabbing or burning pain in the chest when inhaling.”

Answer 1

Pleuritic chest pain

Question 2

What is this a presentation of?

Pleuritic chest pain. Hyperresonant CXR, decreased fremitus, reduced expansion.

Answer 2

Pneumothorax

Question 3

What is this a presentation of?

Pleuritic chest pain. Opacity on CXR, crackles, RTI symptoms, increased fremitus.

Answer 3

Pneumonia

Question 4

What is this a presentation of?

Pleuritic chest pain. Meniscus on CXR, stony dull, decreased fremitus.

Answer 4

Pleural effusion

Question 5

What is this a presentation of?
Pleuritic chest pain. >40 years, smoking/asbestos exposure history, weight loss, haemoptysis, voice change, lymphadenopathy, clubbing.

Answer 5

Fracture, tumour, metastases.

Question 6

What is this a presentation of?

Pleuritic chest pain worse supine, PR depression, widespread ST sharp take-off elevation.

Answer 6

Pericarditis

Question 7

What is this a presentation of?

Pleuritic chest pain, haemoptysis, history of DVT/immobility, malignancy, swollen hot calves, tachycardia, tachypnoea.

Answer 7

Pulmonary embolism

Question 8

What is this a presentation of?

Pleuritic chest pain, recent trauma, upper body activity, tender to palpation, exacerbation of pain on movement.

Answer 8

MSK pathology

Question 9

What is this a presentation of?

Pleuritic chest pain, flu-like symptoms, pleural rub.

Answer 9

Viral pleurisy

Question 10

What are the causes of pleuritic chest pain?

Answer 10

1. Pneumothorax
2. Pneumonia
3. Pleural effusion
4. Fracture, tumour, metastasis
5. Pericarditis
6. Pulmonary embolism
7. MSK pathology
8. Viral pleurisy