CTICasesBilateral Diaphragm Paralysis
Imaging findings
Fluoroscopy shows paradoxical upward movement of the diaphragm during sniffing and a "seesaw" motion (thoraco-abdominal paradox) where the abdomen moves inward as the chest wall expands during breathing.
Key takeaways
Standing radiographs may appear normal. To diagnose bilateral paralysis, always perform a sniff test and, if needed, evaluate the patient in the supine position to reveal paradoxical motion.
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