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Diaphragmatic excursion is the movement of the thoracic diaphragm during breathing. Normal diaphragmatic excursion should be 3–5 cm, but can be increased in well-conditioned persons to 7–8 cm. This measures the contraction of the diaphragm. It is performed by asking the patient to exhale and hold it.
The diaphragm typically appears as two separate, curved outlines (hemidiaphragms) on a chest X-ray due to the heart and mediastinum obscuring its central portion. When air accumulates in the mediastinum or peritoneal cavity, it outlines the diaphragm, making its central portion visible and creating the appearance of a continuous line. [4]
Bochdalek hernia is one of two forms of a congenital diaphragmatic hernia, the other form being Morgagni hernia.A Bochdalek hernia is a congenital abnormality in which an opening exists in the infant's diaphragm, allowing normally intra-abdominal organs (particularly the stomach and intestines) to enter into the thoracic cavity.
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A) Normal chest radiograph; B) Q fever pneumonia affecting the right lower and middle lobes. Note the loss of the normal radiographic silhouette (contour) between the affected lung and its right heart border as well as between the affected lung and its right diaphragm border. This phenomenon is called the silhouette sign: Differential diagnosis
In the average person, the diaphragm should be intersected by the 5th to 7th anterior ribs at the mid-clavicular line, and 9 to 10 posterior ribs should be viewable on a normal PA inspiratory film. An increase in the number of viewable ribs implies hyperinflation, as can occur, for example, with obstructive lung disease or foreign body aspiration.
Chest X-ray is known to be unreliable in diagnosing diaphragmatic rupture; [4] it has low sensitivity and specificity for the injury. [5] Often another injury such as pulmonary contusion masks the injury on the X-ray film. [6] Half the time, initial X-rays are normal; in most of those that are not, hemothorax or pneumothorax is present. [4]
Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver, visible on plain abdominal X-ray or chest X-ray. [1] Normally this causes no symptoms, and this is called Chilaiditi's sign. The sign can be permanently present, or ...