Tactile fremitus is a vibration of the human body that can be felt by placing a hand in the area where the vibration is occurring. It can be a clinical sign and may be checked for during a basic exam in the process of evaluating a patient's symptoms to start thinking about a diagnosis or more testing. There are many different kinds of tactile fremitus, with the most common being tactile vocal fremitus, felt as a buzzing in the chest and back when the patient speaks.
In the case of tactile vocal fremitus, problems with the lungs can result in increased or dampened vibration, or changes in the intensity of the vibration between the lungs. Fluid-filled lungs and chest cavities will vibrate more, for example, and a doctor can find the location of the fluid by carefully feeling the chest and back as the patient is asked to repeat a phrase designed to get the chest to vibrate. Fremitus can also be seen on ultrasound examinations, as the sounds made in the body will interfere with the transducer's signal.
Tactile fremitus can also be experienced with some kinds of inflammatory conditions. Inflamed, swollen organs may vibrate against the body when people move or cough, and this can be felt by a clinician. Crackling sounds and other clinical signs like heat, swelling, or tenderness may also be noted. With conditions involving the lungs, the patient may also be coughing, producing lots of sputum, or having trouble breathing.
Checking for tactile fremitus is a quick, easy, and low-cost way to evaluate a patient. X-rays and other medical imaging studies can be used instead, to check for issues like deposits of fluid or air, swelling, or other abnormalities. When these tests are not available or not cost-effective, or a doctor wants to perform a quick assessment, knowing how to check for tactile fremitus can be valuable. Doctors are usually taught about this and other physical examination techniques while they are in medical school, and they are offered a chance to learn on patients so they know what healthy versus unhealthy patients feel like.
Sometimes people can notice tactile fremitus. If someone has been coughing and having trouble breathing and notices that the chest seems to vibrate more during speech, this can be a sign of fluid in the lungs or around the chest cavity, and it is advisable to seek medical treatment. Patients can mention this symptom to help with the diagnosis and the doctor may verify it by asking the patient to vocalize during a physical exam.