CTICasesAsymmetric Diaphragmatic Crus
Imaging findings
CT in a trauma patient with a horizontal burst fracture of the adjacent vertebral body demonstrates marked asymmetry of the diaphragmatic crura, with the right crus appearing dramatically thickened and raising concern for a post-traumatic hematoma. Subsequent spinal MRI shows normal T1 and T2 signal within the crus, with no evidence of hemorrhage or edema.
Key takeaways
The right diaphragmatic crus is normally thicker than the left, and this physiologic asymmetry can occasionally be very pronounced. In a trauma setting, this normal variation can easily mimic a crus injury or hematoma, but MRI can safely rule out hemorrhage and prevent unnecessary intervention.
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