What does it mean when a cxr shows a 5cm opacity involving the rul and apical segmemt? Pain has sent me to the ER twice and I was told it was pleurisy.

Pulm. Consult. My suggestion...See a pulmonary specialist so they can review the films and your case., determine the need for ct scan, biopsy, sputum analysis infiltrates in the upper lobes are suggestive of tuberculosis but I would be concern about cancer too. All depends upon your whole history, your age any fever, night sweats, blood with sputum, chronic cough, history of smoking or exposure to inhaled toxins.
R U coughing? Have you been exposed to tb? Have you been coughing and wheezing? Are you a smoker? The cough could be pleurisy, which is inflammation/irritation of the lining of the lung and the chest cavity. Pain can also come from dysfunctional ribs caused by the cough itself.
Depends. Doctors usually do not interpret cxr's by themselves. We use all of the clinical information available to us to decide what a finding like the one you describe might mean. Depending on the clinical situation, a 5 CM opacity may be something quite benign to other more serious problems. A conversation with your doctor may help to enlighten you on what this is, and how to pursue it.
Possible Pneumonia. Probably it means pneumonia and to be treated with abx. Repeat chest x-ray after the course of abx at least 2 to 3 weeks to check clearance of that opacity. Always a remote possibility of underlying mass.
Needs workup. 5 cm opacity usually refers to density representing either infection or tumor or atelectasis. This opacity should be further worked up with CT examination. Pleurisy usually manifests as peural thickening and not opacity in lung. Should see internist or pulmonologist for further examination and workup.