Crepitus

Definition

Crepitus is a grating, crackling, or popping sound or sensation produced by: (1) bone-on-bone friction in joints or fracture, (2) tendon movement against bone, or (3) air trapped in subcutaneous tissue (subcutaneous emphysema).

Clinical Types and Causes

• Joint crepitus: Osteoarthritis, cartilage damage.
• Bony crepitus: Fracture with bone fragment movement.
• Subcutaneous emphysema: Pneumothorax, chest trauma, tracheal injury, mediastinal leak after surgery. Feels like 'bubble wrap' when palpated.

Nursing Considerations

Subcutaneous emphysema around the neck or chest after trauma, chest tube placement, or thyroid surgery is a red flag. Assess airway, breathing, and oxygenation. Mark the border with a pen; rapid expansion indicates ongoing leak. Notify the provider immediately.

NCLEX Relevance

Subcutaneous emphysema post-chest tube or trauma is a must-know cue requiring urgent notification.