Decreased or increased resonance is abnormal. Increased resonances can be noted either due to lung distention as seen in asthma, emphysema, bullous disease or due to Pneumothorax. Decreased resonance is noted with pleural effusion and all other lung diseases. Experienced physicians are able to discriminate between dullness of pleural effusion from a consolidation or a mass lesion of lung. The dullness is flat and the finger is painful to percussion with pleural effusion.