elevated hemidiaphragm

• phrenic nerve paralysis: invasive Ca, trauma, aneurysm
• idiopathic: right-sided in males, poss. viral
• subphrenic disease: abscess, peritonitis; pancreas, GB
• neurological disease: polio, peripheral neuritis, zoster
• splinting: chest wall injury
• myotonia congenita
• pulmonary infarct
• eventration
• gaseous distension of stomach or colon

DDx
• Chest fluoro may be helpful to rule out paralysis.
• Basal ("subpulmonic") effusion may mimic elevation.

© 2002, C.E. Kahn, Jr.
2002-04-18