Obligatory medical device diagnostics.
- Thoracic sonography (synonym: thoracic ultrasound; lung ultrasound: here, sonography (ultrasound examination) of the pleura (pleura) – to estimate the extent of the effusion [unilateral or bilateral pleural effusion?; even small amounts (5 ml) of pleural effusion are detectable; detection of pleural septa (septum) is also possible (occur after repeated punctures)/better detection than by computed tomography]
- X-ray of the thorax (radiographic thorax/chest), in two planes [with a p-a image/radiograph in relation to the body from posterior (back) to anterior (front), 150-250 ml of a pleural effusion can be detected/with a lateral image, 50 ml of fluid can be detected; typically, with an image taken in a standing position, a smooth-bordered shadowing rising laterally (outward) (Damoiseau-Ellis line)]
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle).
- Abdominal sonography (ultrasound examination of the abdominal organs) – for basic diagnostics.
Optional medical device diagnostics – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification.
- Computed tomography of the thorax/chest (chest CT) – to exclude pulmonary embolism, malignant (malignant) disease, etc.
- Echocardiography (echo; ultrasound of the heart) – for suspected heart disease such as pericarditis (inflammation of the pericardium) or heart failure (cardiac insufficiency).
- Video thoracoscopy (surgical method of looking into the chest cavity and assessing the pleura) – for taking targeted biopsies (pleural biopsy).
- Bronchoscopy (pulmonary endoscopy) – pleural effusion with concomitant hemoptysis (coughing up blood), bronchial obstruction (permanent narrowing of the airways), or intrapulmonary (within the lungs) mass
- Computed tomography (CT) of the abdomen (abdominal CT) – if intra-abdominal changes are suspected.
- Thyroid sonography (ultrasound examination of the thyroid gland) – if thyroid changes are suspected.
- If necessary, thyroid scintigraphy – if thyroid changes are suspected.
Further notes
- Pleural effusions are more common on the right side because the pleural surface area is larger on that side.
