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Related Experiment Videos

Chest radiography cannot predict diaphragm function.

Alfredo Chetta1, Amer K Rehman, John Moxham

  • 1Respiratory Muscle Laboratory and Radiology Department, Royal Brompton Hospital, London, UK. chetta@unipr.it

Respiratory Medicine
|January 28, 2005
PubMed
Summary
This summary is machine-generated.

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Chest X-rays showing elevated hemidiaphragm are not reliable indicators of diaphragm dysfunction. This study found limited diagnostic value for elevated hemidiaphragm in diagnosing unilateral diaphragm paralysis.

Area of Science:

  • Medical Imaging
  • Pulmonology
  • Diagnostic Accuracy

Background:

  • Elevated hemidiaphragm on chest radiograph is often presumed to indicate severe dysfunction.
  • The diagnostic accuracy of this radiographic finding requires further investigation.

Purpose of the Study:

  • To evaluate the diagnostic value of isolated hemidiaphragm elevation on chest radiographs for detecting unilateral hemidiaphragm dysfunction.

Main Methods:

  • Retrospective review of chest radiographs and twitch transdiaphragmatic pressure (T(W)P(DI)) measurements in 42 patients.
  • Radiographs were independently assessed by two radiologists; diaphragm dysfunction defined as T(W)P(DI) < 3.5 cm H2O.

Main Results:

  • 64% of patients showed unilateral hemidiaphragm elevation on radiography, while only 24% had paralysis by T(W)P(DI).

Related Experiment Videos

  • Chest radiograph sensitivity was 0.90, specificity 0.44, PPV 0.33, and NPV 0.93 for unilateral diaphragm dysfunction.

    • Conclusions:

    • Isolated hemidiaphragm elevation on chest X-ray has limited value in diagnosing unilateral diaphragm paralysis.
    • Absence of diaphragm elevation makes paralysis unlikely, but its presence is not a definitive diagnostic sign.