Diaphragm evaluation (fluoroscopy)

What is a diaphragm evaluation (fluoroscopy)?

A diaphragm fluoroscopy is a diagnostic test that is performed in order to assess the function and movement of the diaphragm, the primary muscle involved in breathing. The test involves the use of a continuous x-ray, which allows your pulmonologist to see the diaphragm move up and down as you breathe and identify any abnormalities that may affect respiratory function.

When is a diaphragm fluoroscopy recommended?

A diaphragm fluoroscopy may be recommended in cases where it is necessary to evaluate breathing difficulties or problems with muscular contraction in the diaphragm. It may also be recommended for the following clinical scenarios:

• Diaphragmatic paralysis: Diaphragmatic paralysis, whether unilateral or bilateral, can significantly impair breathing function. Diaphragm fluoroscopy helps assess the degree of paralysis and its impact on respiratory mechanics.
• Respiratory muscle weakness: Conditions such as neuromuscular diseases (e.g., ALS, myasthenia gravis) or muscular dystrophy can lead to weakness in the respiratory muscles, including the diaphragm. Diaphragm fluoroscopy aids in evaluating the extent of muscle weakness and its effect on breathing.
• Pre-operative assessment: Prior to certain surgeries, especially those involving the chest or abdomen, diaphragm fluoroscopy may be used to assess baseline diaphragmatic function. This information helps surgeons plan the procedure and anticipate potential respiratory complications.
• Evaluation of breathing disorders: In cases of unexplained dyspnea (shortness of breath) or respiratory distress, diaphragm fluoroscopy can provide valuable insights into the underlying cause, such as diaphragmatic dysfunction or paradoxical movement.

What does diaphragm fluoroscopy involve?

During the procedure, you will lie on an examination table and be exposed to an x-ray beam. You will be asked to breathe in and out, hold your breath, and sniff while the images are being taken. These actions activate the diaphragm and allow for a detailed observation of its movement by the pulmonologist.

As you breathe, the fluoroscope captures continuous X-ray images in real time, which are displayed on a monitor. The pulmonologist carefully analyses these images to assess the diaphragm's excursion (movement) during the breathing cycle, including its descent during inhalation and ascent during exhalation. Any abnormalities, such as paradoxical movement or reduced excursion, are noted and evaluated in the context of your clinical history and symptoms.

FAQ

1. Is diaphragm fluoroscopy safe? 2. Are there any risks associated with diaphragm fluoroscopy? 3. How should I prepare for a diaphragm fluoroscopy?