40yr old male asymptotic, past h/o RTA and trauma to left chest



Left dome of diaphragm is elevated in comparison to the right side...the cp angles are clear and there is no rib fracture..bronchovascular markings are visible and pneumothorax is u likely.. As the patient gives history of trauma, the diagnosis is traumatic unilateral diaphragmatic palsy.. Ultrasound chest/abdo will show paradoxical movement of diaphragm dome suggesting palsy.. Usually unilateral diaphragmatic palsy is asymptomatic does not require any treatment... sos niv can be given if patient is short of breath

Reason of Lt pleural thickening?

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Compare with a baseline xray before trauma if available., Possibilities here are eventration nd phrenic nerve palsy Fluoroscopic evaluation diaphragmatic movement is the best way to differentiate

elevation of left dome of diaphragm could be bcoz of phrenic nerve palsy following trauma to left side of chest to rule out go for USG thorax to look for diaphragmatic movement

Pneumothorax lt. Side. Lt dome of diaphragm is elevated. Trachea shifted towards Rt side. Mediastinum pushed towards right side.

Left phrenic nerve palsy following trauma to left side of chest

Diaphragmatic hernia

diaphragm rupture

Left diaphragmatic palsy due to trauma ( diaphragm contour is maintained) Usg thorax helps diagnosis Rx is symptomatic therapy

Elevation of Lt diaphragm.USG abdomen n Thorax will reveal everything.

Blunting of lt cp angle . Usg chest to rule out effusion with palsy

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