Elevated hemidiaphragm

Last revised by David Carroll on 21 Mar 2023

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Carroll D, Weerakkody Y, et al. Elevated hemidiaphragm. Reference article, Radiopaedia.org (Accessed on 30 Mar 2025) https://doi.org/10.53347/rID-1265

DOI:

https://doi.org/10.53347/rID-1265

Permalink:

https://radiopaedia.org/articles/1265?embed_domain=fkgfeaby.ebecbve.dbzX50X8c3X8e

rID:

1265

Article created:

2 May 2008, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

21 Mar 2023, David Carroll

Disclosures:

At the time the article was last revised David Carroll had no financial relationships to ineligible companies to disclose.

View David Carroll's current disclosures

Revisions:

13 times, by 11 contributors - see full revision history and disclosures

Systems:

Chest

Sections:

Gamuts

Tags:

refs, differential, chest imaging

Synonyms:

Elevated hemidiaphragm : differential diagnosis
Hemigraphragmatic elevation

An elevated hemidiaphragm may result from direct and indirect causes which include:

above the diaphragm ¹
- decreased lung volume
  - atelectasis/collapse
  - prior lobectomy or pneumonectomy
  - pulmonary hypoplasia
  - pulmonary fibrosis
diaphragm ^3-7
- phrenic nerve palsy
- cervical myelopathy
- neuromuscular disease ¹¹
- diaphragmatic eventration
- contralateral stroke
  - usually middle cerebral artery (MCA) distribution
below the diaphragm ⁸
- abdominal tumour, e.g. liver metastases or primary malignancy
- subphrenic abscess
- organomegaly
  - hepatomegaly
  - splenomegaly ¹²
- distended hollow viscus e.g. stomach or colon
  - Chilaiditi sign/syndrome

Differential diagnosis

Other situations which may mimic an elevated hemidiaphragm include:

References

1. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
2. Khan AN, Al-Jahdali H, Al-Ghanem S et-al. Reading chest radiographs in the critically ill (Part II): Radiography of lung pathologies common in the ICU patient. Ann Thorac Med. 2009;4 (3): 149-57. doi:10.4103/1817-1737.53349 - Free text at pubmed - Pubmed citation
3. Mangera Z, Panesar G, Makker H. Practical approach to management of respiratory complications in neurological disorders. Int J Gen Med. 2012;5: 255-63. doi:10.2147/IJGM.S26333 - Free text at pubmed - Pubmed citation
4. Qureshi A. Diaphragm paralysis. Semin Respir Crit Care Med. 2009;30 (03): 315-20. doi:10.1055/s-0029-1222445 - Pubmed citation
5. Tiryaki T, Livanelioğlu Z, Atayurt H. Eventration of the diaphragm. Asian J Surg. 2006;29 (1): 8-10. doi:10.1016/S1015-9584(09)60285-2 - Pubmed citation
6. Wu MN, Chen PN, Lai CL et-al. Contralateral diaphragmatic palsy after subcortical middle cerebral artery infarction without capsular involvement. Neurol. Sci. 2011;32 (3): 487-90. doi:10.1007/s10072-011-0501-z - Pubmed citation
7. Kumar S, Reddy R, Prabhakar S. Contralateral diaphragmatic palsy in acute stroke: an interesting observation. Indian J Crit Care Med. 2009;13 (1): 28-30. doi:10.4103/0972-5229.53113 - Free text at pubmed - Pubmed citation
8. Krige JE, Beckingham IJ. ABC of diseases of liver, pancreas, and biliary system. BMJ. 2001;322 (7285): 537-40. Free text at pubmed - Pubmed citation
9. Nason L, Walker C, McNeeley M, Burivong W, Fligner C, Godwin J. Imaging of the Diaphragm: Anatomy and Function. Radiographics. 2012;32(2):E51-70. doi:10.1148/rg.322115127 - Pubmed
10. Guo C, Liu L, Zhang J et al. Analysis of Clinicopathological Features of Primary Diaphragm Tumors: A Single‐center Study. Thorac Cancer. 2021;12(12):1810-3. doi:10.1111/1759-7714.13988 - Pubmed
11. Hynås I, Ganes T, Naalsund A. [Acute Respiratory Failure Caused by Myotonic Dystrophy]. Tidsskr Nor Laegeforen. 2001;121(19):2278-9. - Pubmed
12. Ziakas P, Voulgarelis M, Felekouras E, Anagnostou D, Tzelepis G. Myelofibrosis-Associated Massive Splenomegaly: A Cause of Increased Intra-Abdominal Pressure, Pulmonary Hypertension, and Positional Dyspnea. Am J Hematol. 2005;80(2):128-32. doi:10.1002/ajh.20388 - Pubmed