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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Saturday, November 7, 2009
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Saturday, November 7, 2009
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Lung Center |
Elevation of hemidiaphragm11/27/2006 |
I had a CT of the Chest which indicates a smooth elevation of the right hemidiaphragm which contains only normal-appearing liver. It also indicates there is evidence of old granulomatous disease with calcified AP window and left hilar lymph nodes. What does this mean? The CT was performed because I had flulike symptoms recently with a cough, and my physician ordered a chest xray which stated there was a possible eventration of the right hemidiaphragm.
The diaphragm is a thin muscle that separates the abdomen (belly) from the thorax (chest) and contracts and relaxes with breathing. It is very important for air movement in and out of the lungs.
An eventration is a herniation of abdominal contents-intestine, liver, stomach from the abdomen into the chest through a hole in the diaphragm. The chest CT scan should have determined whether an eventration was present.
Other causes for an elevation of the right hemidiaphragm include the liver pushing the diaphragm upward, fluid within the abdomen (ascites) pushing the diaphragm upward, weakness or paralysis of the diaphragm muscle causing it to dome up into the thorax.
Weakness or paralysis of the diaphragm muscle is determined by a sniff test. Under fluoroscopic (xray) imaging, an individual sniffs in. This movement should cause the diaphragm to move downward; if it doesn't move or moves upward, weakness or paralysis of the diaphragm is diagnosed. Unless you have symptoms of breathlessness (especially with lying down) it is unlikely that you have diaphragm weakness or paralysis.
Calcified lymph nodes in the middle of the chest are usually due to prior infection especially granulomatous infections such as fungal infections or tuberculosis. Fungal infections occur in parts of the country such as the Ohio River basin routinely and are very common. The calcifications are a form of scarring within the infected lymph nodes and suggest that the infection occurred in the past.
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Ralph Panos, MD Associate Professor Pulmonary, Critical Care & Sleep Medicine Department of Internal Medicine College of Medicine University of Cincinnati |
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