Continuous Diaphragm Sign

Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California.
The western journal of emergency medicine 11/2011; 12(4):526-7. DOI: 10.5811/westjem.2011.4.2283
Source: PubMed
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Available from: Eric R Schmitt
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    ABSTRACT: PURPOSE/AIM 1. Review normal anatomy and appearance of the diaphragm on CXR’s 2. Learn imaging features associated with pulmonary and extrapulmonary pathologies 3. Demonstrate an image based interpretation algorithm to facilitate imaging selection and diagnosis CONTENT ORGANIZATION A review of anatomy and plain film appearance of the diaphragm is followed by a discussion of pulmonary and extrapulmonary pathologies associated with abnormal diaphragmatic configurations. CT and MR correlation will be provided in select cases. Cases are presented in a quiz format to emphasize major teaching points. Abnormalities presented include: Contour abnormalities: Subpulmonic effusion, drop metastasis, tumor (pleural and diaphragm), juxtaphrenic peak Defects: Hernias (Morgagni, Bochdalek, and hiatal), rupture Flattening: COPD, Alpha-1-antitrypsin, lymphangioleiomyomatosis Elevation: Liver lesions, paralysis, lupus Adjacent lucency: Pneumomediastinum, pneumothorax, pneumoperitoneum Calcifications: Asbestosis, fibrothorax SUMMARY Variations in the appearance of the diaphragm on CXR’s may be due to pulmonary, neural, abdominal or pleural pathology. After viewing this module, the user will be familiar with common causes for alterations in the appearance of the diaphragm. An algorithm is provided to facilitate appropriate additional imaging selection.
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