Diagnosis for pleurisy includes a physical exam and discussion of symptoms. The pain associated with pleurisy is a distinguishing characteristic and often helps a doctor make a diagnosis. It typically involves the quick onset of sharp chest pain during breathing. The doctor will use a stethoscope to listen to breathing, which generally makes a squeaking or rubbing sound due to friction. After diagnosis, the doctor may order additional tests to determine the underlying cause. These tests may include x-rays, CT scans, blood tests, analysis of fluid in the pleural cavity, EKG, or ultrasound.