Crepitations

Crepitations, in a medical context, refer to abnormal crackling sounds heard during auscultation of the lungs. Also described as crackles, they are most often detected with a stethoscope during inspiration and can be described as fine, high-pitched or coarse, louder, and longer. The term is more commonly used in British medical literature; in many English-language sources the same findings are referred to as crackles.

Cause and appearance

Fine crepitations are soft, brief, and high-frequency, typically indicating fluid-filled or inflamed alveolar regions, as seen in early pneumonia, pulmonary edema, or interstitial fibrosis. Coarse crepitations are louder and longer, often arising from secretions in larger airways or from air passing through airways partially obstructed by mucus, as may occur with bronchitis or resolved atelectasis. Crepitations may be localized or bilateral and are often more evident at the lung bases, but distribution depends on the underlying condition.

Clinical significance

Crepitations are a diagnostic clue rather than a diagnosis themselves. They help distinguish certain pulmonary processes from others that produce different auscultatory findings, such as dry wheezes or rhonchi. The presence, absence, type, and distribution of crepitations, along with patient symptoms and history, guide further evaluation and management. They can be transient or persistent, and their configuration may change with treatment.

Assessment, diagnosis, and management

Assessment includes careful auscultation, patient position, and comparison with prior exams. Diagnostic workup may involve chest imaging (X-ray or CT), laboratory tests, and, when indicated, oxygen assessment and cardiac evaluation. Treatment targets the underlying cause, such as diuretics for edema, antibiotics for pneumonia, or therapies for interstitial lung disease and atelectasis.

Other uses

The term crepitations can also describe a crackling sensation or sound in soft tissues or joints (crepitus) or in subcutaneous emphysema, but in this article the focus is on pulmonary crepitations.