CTICasesParsonage-Turner Syndrome
Imaging findings
Serial chest radiographs demonstrate normal hemidiaphragm heights in 2018, followed by a steep, pronounced elevation of the left hemidiaphragm in 2020. Sniff test under fluoroscopy shows lack of normal excursion on deep inspiration and paradoxical upward movement of the left hemidiaphragm on sniffing. Chest CT shows progressive thinning of the left diaphragmatic crus and anterior muscular component.
Key takeaways
Parsonage-Turner syndrome (neuralgic amyotrophy) is a painful brachial plexus and phrenic neuropathy, often post-viral or autoimmune in nature, leading to acute diaphragmatic paralysis. The acute onset is typically heralded by severe shoulder and neck pain followed by dyspnea. While many cases resolve spontaneously within a year, some patients are left with permanent diaphragmatic weakness or paralysis.
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