[Can pleurisy be detected with ultrasound?]

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.

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.

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.

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.