CTICasesTransient Diaphragmatic Paralysis Secondary to Interscalene Block
Imaging findings
Postoperative portable chest radiographs following a major upper extremity resection demonstrate a newly elevated left hemidiaphragm. A subsequent radiograph obtained two days later shows resolution of the diaphragmatic elevation, with the hemidiaphragm returning to its normal position.
Key takeaways
Transient phrenic nerve palsy and resulting diaphragmatic hemiparalysis are well-known side effects of interscalene brachial plexus blocks, occurring in up to 100% of cases when standard volumes of local anesthetic are used. The condition is usually self-limiting and resolves once the anesthetic wears off, though continuous catheter-based infusions can prolong the duration of diaphragmatic elevation.
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