Common things about the Diaphragm

Things you should know about the normal diaphragm

Things you should know about the normal diaphragm-

  • It is dome-shaped.
  • The right diaphragm is usually higher than the left side, probably left diaphragm is pushed by the heart downwards.
  • In a few cases, the left diaphragm may be of the same height as that of the right and in a few cases, it may be lower than the left. 
  • The difference between the diaphragms is less than 3 cm in height. If the difference between the diaphragms is more than 3 cm, then you should consider it pathological.

A diaphragmatic hump- It is a focal elevation in the diaphragm, which shouldn’t be confused with any abnormal pathology.

Right diaphragmatic hump- yellow arrow.

Causes of Unilateral diaphragmatic elevation-

The unilateral diaphragmatic elevation is seen in –

a. Eventration of the diaphragm( focal weaking of diaphragm).

b. Diaphragmatic palsy ( paralysis)

c.  Diseases pushing the diaphragm upwards ( Liver abscess, Hepatomegaly, etc).

d. Pulling of diaphragm upwards due to lower lobe collapse or fibrosis.

Eventeration is the elevation of the diaphragm because the diaphragm is focally weak. It is usually unilateral.

Diaphragmatic palsy maybe because of some mass in the mediastinum which is causing infiltration of the phrenic nerve which supplies the diaphragm.

These two entities will be impossible to separate in X-ray and you will need to do an ultrasound examination, which will help in separating the two entities by looking at the motion of the diaphragm.

Elevation of the diaphragm on the right side, due to Diaphragmatic eventration.

Qn. What are the common causes of bilateral diaphragmatic elevation?

Bilateral diaphragmatic elevation maybe because of the following causes-

a. Bilateral diaphragmatic palsy because of systemic diseases like diabetes, uremia, etc.

b. Bilateral diaphragmatic eventration ( Very rare ).

c.  Because of pushing from the abdomen ( ascites, pregnancy, large abdominal mass, etc).

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