396. Elevation of the diaphragm (unilateral)

หญิง 55 ปี มาตรวจสุขภาพ ไม่มีอาการผิดปกติ CXR เป็นดังนี้ ดิคถึงภาวะใด Elevation of the diaphragm, unilateral
-Common causes: invasion of phrenic nerve by tumor, trauma
Most reliable manoeuvre for detecting hemi-diaphragmatic paralysis is sniff test performed while visualizing diaphragm with fluoroscopy or ultrasound-Thoracic causes: atelectasis, splinting of diaphragm due to acute process (fractured rib, pleurisy, pneumonia), postoperative (lobectomy, pneumonectomy)
-Abdominal causes: distended stomach, interposition of colon between liver and right hemidiaphragm (Chilaiditi syndrome), subphrenic abscess, hepatomegaly, abdominal neoplasm
ผู้ป่วยได้รับการทำ ultrasound : not found structural abnormality

http://imaging.consult.com/topic/Elevation-of-the-Diaphragm,-Unilateral/S1933-0332(07)70289-6