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Friction rubs are dry, cracking, and grating sounds caused by inflamed, roughened surfaces rubbing together. Due to the irritation in pericarditis and pleurisy, effusions will develop, and the friction rub will no longer be heard. The friction rub, heard early in the course, may be transient in both conditions and can cause significant pain.
So, the next time you hear a “grating” sound in the chest during your assessment, have the patient hold their breath. In pericarditis it will persist with breath holding. It will disappear (in additional to a pleural friction rub) as an effusion develops.