Ultrasound utilization in the diagnosis of diaphragm dysfunction compared to other modalities: A retrospective study

Diaphragm is dome-shaped fibro-muscular assembly, composed of central tendon surrounded by peripheral muscle fibers. It plays a significant role in respiration and maintenance of lumber spine stability. Any condition that interferes with diaphragmatic innervation, contractile muscle function or mechanical coupling to chest wall can cause diaphragm dysfunction; which is usually manifests as elevation at chest radiography. Functional imaging with M-mode ultrasonography has been used in assessment of diaphragm kinetics in a variety of normal and pathological conditions. In this study, we evaluate the departmental ultrasound accuracy in diaphragm motion assessment and compare its results with other institutional parameters.

We retrospectively reviewed the recorded laboratory investigation and chest radiograph of 163 pediatric patients. A total of 131 patients met clinical inclusion criteria for our study, patients under age of 14 years having clinical suspicion of diaphragmatic dysfunction. Patients having neuromuscular blockers, surgical plication, and phrenic nerve pacing were excluded. The mean age was 1.6 (SD 2.6) years and there were 44.3% of male and 55.7% of female patients.

The data demonstrated that ultrasonography is a highly sensitive and specific diagnostic tool compared to X-ray and laboratory investigation and clinical suspicion. The second-best results were obtained by X-ray and less accurate results were obtained by laboratory investigation.

In proper sonographic technique; diaphragmatic ultrasound appears to be a valid and reliable diagnostic too; for diaphragmatic dysfunction. Diaphragm ultrasound may act as an imaging tool guiding rehabilitation success in diaphragmatic dysfunction cases.