The Process of Diagnosing and Treating Fluid in the Lungs

Diagnosing of Pleural Effusion. A physical exam is the first step in diagnosing pleural effusion. Doctors will listen to the chest with a stethoscope to evaluate the sounds produced when tapping on the chest or back. They will also check to see that both lungs are inflating and deflating equally. Reduced breathing sounds or a “friction rub” may be audible. A friction rub is a sound that the heart makes when it rubs against the fluid-filled pleural space. Doctors will also look at the patient’s history for common conditions that could cause the fluid to build. The doctor may then order tests such as chest x-rays, a CT scan or an ultrasound to locate the fluid. A thoracentesis may be ordered to get a small sample of the fluid by inserting a catheter into the pleural space. Fluid samples can be analyzed to categorize it for treatment while obtaining cultures, cell counts and testing liver and kidney function.