Causes and Diagnoses
Causes and Diagnoses of Disorders of the Diaphragm
Disorders of the diaphragm can have a variety of causes, depending on the type of disorder, ranging from being present at birth to major trauma. Causes may include:
- Congenital diaphragmatic hernia (CDH):
- An unknown defect occurs during fetal development
- Acquired diaphragmatic hernia (ADH):
- Blunt trauma from car accidents or falls
- Stab wounds
- Gunshot wounds
- Hiatal hernia:
- Straining to move your bowels
- Sudden physical movement, such as lifting
- Diaphragmatic tumor:
- Benign (noncancerous) tumors
- Cancerous tumors metastasizing (spreading) from the lungs or liver
- Paralysis of the diaphragm:
- Lung or lymph cancer that compresses the phrenic nerve
- Surgical trauma
- Birth trauma to phrenic nerve
- Injury to the phrenic nerve or the spinal cord
- Neuromuscular disorders, such as ALS and MS
- Thyroid disease
- Autoimmune disease
Diagnosing Disorders of the Diaphragm
Diagnosis of a diaphragm disorder will begin with a physical exam and discussion of your symptoms. Tests may include:
- X-ray: A chest X-ray can identify the presence of blockages or fluids creating pressure.
- Computed tomography (CT) scan: This test combines X-ray and computer technology to produce detailed cross-sectional images of your chest cavity.
- Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) creates detailed images of organs and other body structures using a large magnet, a computer and radiofrequencies. Unlike computed tomography (CT or CAT) scans or X-rays, MRI does not use radiation.
- Ultrasound: This type of imaging captures movement to detect any irregularities in the diaphragmatic function.
- Pulmonary function tests while upright and lying down, including:
- Spirometry: This test measures the quantity and speed of air you exhale to estimate how much your bronchial tubes are inflamed and narrowed.
- Peak flow meter: This device measures how hard you can exhale. Peak flow meters can be used at home to monitor your condition.
- Exercise oximetry: This checks the oxygen level in your blood during moments of exertion with a sensor that’s clipped onto your finger.
- Arterial blood gas: This blood test checks the amount of oxygen and carbon dioxide in your blood and measures your blood’s acidity.
- Phrenic nerve stimulation test: This test uses electric or magnetic stimulation to the neck to measure the response of the phrenic nerve.
- Electromyography (EMG): This test measures the electrical potential of muscle fibers stimulated by electrical impulses.