What are the key clinical features that suggest a pleural effusion in a patient presenting with respiratory symptoms?

Key clinical features suggesting a pleural effusion in a patient with respiratory symptoms include:

• Reduced chest expansion on the affected side.
• Stony dull percussion note over the affected area.
• Absent or decreased breath sounds on the affected side.
• Typically no added breath sounds such as crepitations or wheeze.
• Possible lateralized pleuritic chest pain.
• Shortness of breath, which may be unexplained or associated with other symptoms like cough or fatigue.

These features are important to identify as they guide the need for urgent chest X-ray and further investigations to confirm the diagnosis and underlying cause.

In summary, the combination of reduced chest expansion, stony dullness to percussion, and decreased breath sounds on one side strongly suggests a pleural effusion in a patient presenting with respiratory symptoms.

References: NICE CKS, NICE NG12