CTICasesDiaphragm tethering by pleural thickening
Imaging findings
Fluoroscopy shows restricted excursion and tethered motion of the left hemidiaphragm in a patient with a thickened, chronic pleural process. CT confirms normal thickness of the diaphragmatic crura.
Key takeaways
Pleural thickening or trapped lung can mechanically restrict or tether diaphragmatic motion, simulating diaphragmatic paralysis on fluoroscopy. Normal thickness of the crura on CT helps differentiate mechanical tethering from phrenic nerve palsy.
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