[Exploring the diaphragm: Ultrasound is essential]

The diaphragm is the muscle most implicated in breathing. Its morphological exploration usually depends on pulmonary radiography, fluoroscopy, CT-scanning and MRI. Its function is evaluated by the classical respiratory functional tests, the measurement of maximum inspiratory and expiratory pressures, the transdiaphragmatic pressure and even an electromyogram. Ultrasound is a technique still insufficiently used in respiratory medicine. It offers, however, many advantages: it is easy to implement, there is no irradiation, it is usable at the bedside, particularly when the patient is immobile or in intensive care. The results of the examination are immediately available. It allows morphological and dynamic study of each hemidiaphragm as well as providing invaluable information on the thoracic and subdiaphragmatic environment. Its field of exploration is extremely wide: raised hemidiaphragm, dyspnea following a stroke or a surgical procedure (thoracic or abdominal), road accident trauma, diagnosis and follow-up of a paresis or paralysis, evaluation of diaphragmatic mobility during the course of COPD (Chronic Obstructive Pulmonary Disease) and many other pathologies. Ultrasound is insufficiently used in pleural disease and even less so in the evaluation of the morphology and function of the diaphragm.