Examination

Signs due to pleural effusion:

• Respiratory distress
• Dyspnoea
• Hypoxia
• Asymmetrical lung expansion
• Reduced breath sounds
• Reduced tactile vocal fremitus
• Stony dull to percussion
• Tracheal deviation

Signs due to underlying cause:

• Clubbing
• Cachexia
• Lymphadenopathy
• Peripheral oedema
• Raised JVP
• Ascites
• Peripheral stigmata of cardiac/renal/liver disease
• Previous operative scars or radiotherapy marks
• Signs of DVT
• Nicotine staining
• Signs of connective tissue disease