CTICasesDiaphragm paralysis diagnosed by supine fluoroscopy
Imaging findings
Sniff test and fluoroscopy demonstrate normal diaphragmatic excursion while standing, which completely disappears/fails when the patient is placed supine. CT shows thinning of the diaphragmatic crura and low lung volumes.
Key takeaways
Patients with diaphragmatic paralysis can use abdominal muscle contraction during standing to achieve pseudo-inspiration. Placing the patient supine defeats this compensatory mechanism, revealing the true lack of diaphragmatic excursion.
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