Imaging of pleural disease

•. Chest radiography is the imaging modality of choice in the initial investigation of pleural disease. •. Ultrasound is useful in the detection of pleural fluid and in guiding interventional procedures such as thoracentesis, needle biopsy and placement of drainage catheters. Ultrasound may also have a role in the rapid detection of pneumothorax in the acute setting. •. CT is used for the further characterization of pleural abnormalities seen on ultrasound and chest radiography and may also be used to guide interventional procedures. •. MRI and nuclear medicine, at present, have a limited role in imaging pleural disease. Imaging plays a vital role in the diagnosis and management of pleural disease. This review aims to discuss the most important pleural diseases. It will describe the role of the different imaging modalities including plain radiography, ultrasound, CT, MRI and positron emission tomography in the diagnosis and management of pleural disease. It will also discuss the role of image-guided intervention.