Eventration of diaphragm radiology

Results Of 32 patients with elevated diaphragm on chest radiograph, 17 had diaphragmatic paralysis confirmed with fluoroscopic sniff test. Our results indicate that the radius of curvature or shape of the diaphragm on lateral chest radiograph is the most important factor for detection of the presence or absence of diaphragmatic paralysis. HH/APD > 0.28 suggests against paralysis. Section snippets Materials and methods The posteroanterior and lateral radiographs of 32 consecutive patients who underwent fluoroscopic sniff test for elevated diaphragm between 2003 and 2005 were retrospectively reviewed. Inclusion criteria were all patients with fluoroscopic sniff test for evaluation of elevated hemidiaphragm identified on chest radiograph. Those patients without both the posteroanterior and lateral view chest radiographs and those patients with greater than 1 month between their chest radiographs and Results Thirty-two patients were included in this study and consisted of 18 male and 14 female patients with an average age of 41 years (range, 3 months–75 years). There were 20 right and 12 left elevated hemidiaphragms. Of the 32 elevated hemidiaphragms initially identified on posteroanterior/lateral chest radiograph, 17 (53%) had hemidiaphragm paralysis, which was subsequently confirmed with fluoroscopic sniff test. The average elevated hemidiaphragm dome corresponded to the T8 vertebral body level Discussion Our results suggest that conventional chest radiography may be a usefu...

Article: • • • • • • • Images: • • Epidemiology No single demographic is affected, as there are numerous causes of a phrenic nerve palsy. The epidemiology will therefore match that of the underlying etiology. Clinical presentation Clearly, presentation will depend on the underlying cause. In many cases of unilateral (majority of cases) phrenic nerve paralysis, patients are asymptomatic 7. When presentation is directly attributable to phrenic nerve palsy, then patients typically report dyspnea and orthopnea. Respiratory function tests tend to have a restrictive pattern 1. In cases of bilateral phrenic nerve paralysis, symptoms are not surprisingly more pronounced but are particularly exacerbated when recumbent 1. Pathology Etiology Many cases are idiopathic or thought to be postviral 8,9. Common causes include: • malignancy • • • mediastinal tumors or neck malignancy • trauma and iatrogenic • penetrating injury • chiropractic manipulation 1 • postoperative: especially cardiac: up to 10% of cases 7,9,11 • 2,6 • direct trauma • compression by hematoma • local anesthetic infiltration • • incidence reduced with ultrasound guidance and use of lower volumes of local anesthetic 12 • forceps delivery (newborn) 5 • neuromuscular diseases • 9 • 3 • inflammation • • • • herpes zoster infection 4 • direct compression • • cervical osteophytes Radiographic features Plain radiograph In some cases the diagnosis is obvious. However, as diaphragmatic position is not symmetric, an understandi...

Diaphragm Eventration Diaphragmatic eventration results from localized atrophy of the diaphragm muscle or from part of the diaphragm being replaced with fibroelastic tissue. From: Goldman's Cecil Medicine (Twenty Fourth Edition), 2012 Related terms: • Volvulus • Patient • Hernia • Stomach Volvulus • Diaphragm • Congenital Diaphragm Hernia • Hemidiaphragm • Diaphragm Paralysis • Plication Nathaniel Koo, ... Namasivayam Ambalavanan, in Goldsmith's Assisted Ventilation of the Neonate (Seventh Edition), 2022 Diaphragmatic paralysis/eventration Diaphragmatic paralysis and eventration can be lumped together because it is virtually impossible to distinguish them from each other. They look alike and act in a similar fashion. If a neonate has had a traumatic birth and has other neurologic deficits or if the baby has undergone intrathoracic surgery, it is reasonable to assume that the child has paralysis. If those conditions are not met, it is just as likely to be one lesion as the other. In both conditions, one or both diaphragms assume a high position on chest X-ray and may compromise function of the lung owing to compression. Fluoroscopy or sonographic evaluation for paradoxical motion suggests paralysis, but a thin, attenuated muscle may give very similar results. In addition to the space problems, the paradoxical motion creates increased work of breathing, tires the baby, and makes effective spontaneous ventilation difficult. If either of these conditions is present but asympto...

• Etiology: congenital lack of muscle fibers in the diaphragm • Imaging: focal elevation of the hemidiapragm, hemidiaphragm does show movement on fluoroscopy and ultrasound • Treatment: excision of fibrous portion of diaphragm Radiology Cases of Diaphragm Eventration CXR PA and lateral (above) shows a right sided anteromedial opacity that obscures the right heart border on the PA image and the anterior portion of the right hemidiaphragm on the lateral image. Fluoroscopy showed the opacity to move synchronously with the diaphragm during normal respiration. Axial CT with contrast of the chest (below) shows the source of the opacity to be the liver positioned within the anteromedial lower right hemithorax.