Abstract
The diaphragm is the primary muscle of ventilation. Diaphragmatic disease usually manifests as an elevation in the chest radiograph. Functional imaging with fluoroscopy (or image ultrasound or MRI) is a simple and effective method in the diagnosis of diaphragmatic dysfunction, which can be classified as paralysis, weakness, or hernias. The pathology of the diaphragm can be divided into impaired mobility and position (paralysis, paresis and incisional hernia), hernias and diaphragmatic defects: congenital (Bochdalek, Morgagni), acquired (hiatal hernia, hernia traumatic) diaphragmatic tumors, and congenital (accessory diaphragm).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Pneumoperitoneum
Baker SR (1997) Unenhanced helical CT versus plain abdominal radiography: a dissenting opinion. Radiology 205(1):45–47
Balthazar EJ, Moore SL (1996) CT evaluation of infradiaphragmatic air in patients treated with mechanically assisted ventilation: a potential source of error. AJR Am J Roentgenol 167(3):731–734
Cho KC, Baker SR (1997a) Depiction of diaphragmatic muscle slips on supine plain radiographs: a sign of pneumoperitoneum. Radiology 203(2):431–433
Cho KC, Baker SR (1997b) Visualization of the extrahepatic segment of the ligamentum teres: a sign of free air on plain radiographs. Radiology 202(3):651–654
Earls JP, Dachman AH, Colon E (1993) Prevalence and duration of postoperative pneumoperitoneum: sensitivity of CT vs left lateral decubitus radiography. AJR Am J Roentgenol 161(4):781–785
Miller RE (1973) The technical approach to the acute abdomen. Semin Roentgenol 8(3):267–279
Radin R, Van Allan RJ, Rosen RS (1996) The visible gallbladder: a plain film sign of pneumoperitoneum. AJR Am J Roentgenol 167(1):69–70
Woodring JH, Heiser MJ (1995) Detection of pneumoperitoneum on chest radiographs: comparison of upright lateral and posteroanterior projections. AJR Am J Roentgenol 165(1):45–47
Diaphragmatic Eventration
Gierada DS, Slone RM, Fleishman MJ (1998) Imaging evaluation of the diaphragm. Chest Surg Clin N Am 8(2):237–280
Moinuddeen K, Blatzer JW et al (2001) Diaphragmatic eventration: an uncommon presentation of a phrenic nerve schwannoma. Chest 119(5):1615–1616
Rubinstein Z, Solomon A (1981) CT findings in partial eventration of the right diaphragm. J Comput Assist Tomogr 5(5):719–721
Watanabe S, Shimokawa S et al (1998) Large eventration of diaphragm in an elderly patient treated with emergency plication. Ann Thorac Surg 65(6):1776–1777
Worthy SA, Young KE et al (1995) Diaphragmatic rupture: CT findings in 11 patients. Radiology 194:885–888
Hiatal Hernia
Abbara S, Kalan MMH, Lewicki AM (2003) Intrathoracic stomach revisited. AJR Am J Roentgenol 181:403–414
Huang SY, Levine MS, Rubesin SE, Katzka DA, Laufer I (2007) Large hiatal hernia with floppy fundus: clinical and radiographic findings. AJR Am J Roentgenol 188:960–964
Morgagni Hernia
Minneci PC et al (2004) Foramen of Morgagni hernia: changes in diagnosis and treatment. Ann Thorac Surg 77:1956–1959
Bragg WD, Bumpers H, Flynn W (1996) Morgagni hernias: an uncommon cause of chest masses in adults. Am Fam Physician 54(6):2021–2024
Nasr A, Fecteau A (2009) Foramen of Morgagni hernia: presentation and treatment. Thorac Surg Clin 19:463–468
Sandstrom CK, Stern EJ (2011) Diaphragmatic hernias: a spectrum of radiographic appearances. Curr Probl Diagn Radiol 40(3):95–115
Horton JD, Hofmann LJ, Hetz SP (2007) Presentation and management of Morgagni hernias in adults: a review of 298 cases. Surg Endosc 22:1412–1420
Pineda V, Andreu J, Caceres J et al (2007) Lesions of the cardiophrenic space: findings at cross-sectional imaging. Radiographics 27:19–32
Diaphragmatic Sarcoma
Eustace S, Fitzgerald E (1993) Primary rhabdomyosarcoma of the diaphragm: an unusual cause of adolescent pseudo-achalasia. Pediatr Radiol 23:622–623
Raney RB, Anderson JR, Andrassy RJ, Crist WM, Donaldson SS, Maurer HM (2000) Soft-tissue sarcomas of the diaphragm: a report from the Intergroup Rhabdomyosarcoma Study Group from 1972 to 1997. J Pediatr Hematol Oncol 22:510–514
Rud NP, Reiman H, Pritchard DT, Frassica FJ, Smithson WA (1989) Extraosseous Ewing’s sarcoma: a study of 42 cases. Cancer 64:1548–1553
Weksler B, Ginsberg RJ (1998) Tumors of the diaphragm. Chest Surg Clin N Am 8:441–447
Diaphragmatic Hernia
Iochum S, Ludig T et al (2002) Imaging of diaphragmatic injury: a diagnostic challenge? Radiographics 22:S103–S118
Sliker CW (2006) Imaging of diaphragm injuries. Radiol Clin North Am 44:199–211
Unilateral Diaphragmatic Paralysis
Dernaika TA, Younis WG, Carlile PV (2008) Spontaneous recovery in idiopathic unilateral diaphragmatic paralysis. Respir Care 53(3):351–354
Freedman B (1950) Unilateral paralysis of the diaphragm and larynx associated with inflammatory lung disease. Thorax 5:169
Kara M et al (2006) Unilateral diaphragm paralysis possibly due to cervical spine involvement in multiple myeloma. Med Princ Pract 15:242–244
McCool FD, Tzelepis GE (2012) Dysfunction of the diaphragm. N Engl J Med 366:932–942
Stowasser M, Cameron J, Oliver WA (1990) Diaphragmatic paralysis following cervical herpes zoster. Med J Aust 153(9):555–556
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Pupo, J.C.P., Pupo, J.C.P., Pupo, J.C.P., Pinzón, D.P. (2013). Diaphragm. In: Pedrozo Pupo, J. (eds) Learning Chest Imaging. Learning Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34147-2_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-34147-2_2
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-34146-5
Online ISBN: 978-3-642-34147-2
eBook Packages: MedicineMedicine (R0)