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Related Experiment Videos

Differentiating diaphragmatic paralysis and eventration.

Peter T Verhey1, Marc V Gosselin, Steven L Primack

  • 1Department of Radiology, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239, USA. verheyp@ohsu.edu

Academic Radiology
|March 21, 2007
PubMed
Summary

Chest radiography can effectively assess diaphragmatic paralysis in elevated diaphragms. Evaluating the diaphragm's shape on lateral views is key, potentially replacing the need for a fluoroscopic sniff test.

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Diagnostic Imaging

Background:

  • Diaphragmatic elevation on chest X-rays can be challenging to differentiate from paralysis or eventration.
  • Conventional radiography is often considered insufficient for definitive diagnosis.

Purpose of the Study:

  • To assess the utility of conventional chest radiography in diagnosing diaphragmatic paralysis.
  • To quantitatively and qualitatively evaluate chest X-rays for diaphragmatic function in elevated diaphragms.

Main Methods:

  • Retrospective analysis of 32 patients with elevated diaphragms who underwent fluoroscopic sniff tests.
  • Radiologists assessed diaphragm shape and position on PA and lateral radiographs.
  • Measurements of skeletal landmarks and diaphragm radius of curvature were correlated with sniff test results.

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Main Results:

  • 17 out of 32 patients had confirmed diaphragmatic paralysis.
  • Diaphragm shape, specifically the radius of curvature on lateral views, was the most significant indicator.
  • A height-to-anterior-posterior-diameter ratio (HH/APD) > 0.28 suggested the absence of paralysis.

Conclusions:

  • Conventional chest radiography is a valuable tool for evaluating elevated diaphragms.
  • Assessing the diaphragm's shape on lateral chest X-rays may eliminate the need for fluoroscopic sniff tests.