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Kehr's sign is a classic example of referred pain: irritation of the diaphragm is signaled by the phrenic nerve as pain in the area above the collarbone. This is because the supraclavicular nerves have the same cervical nerves origin as the phrenic nerve, C3, C4, and C5.
The diaphragm typically appears as two separate, curved outlines (hemidiaphragms) on a chest X-ray due to the heart and mediastinum obscuring its central portion. When air accumulates in the mediastinum or peritoneal cavity, it outlines the diaphragm, making its central portion visible and creating the appearance of a continuous line. [4]
Chest X-ray is known to be unreliable in diagnosing diaphragmatic rupture; [4] it has low sensitivity and specificity for the injury. [5] Often another injury such as pulmonary contusion masks the injury on the X-ray film. [6] Half the time, initial X-rays are normal; in most of those that are not, hemothorax or pneumothorax is present. [4]
AP chest x-rays are harder to read than PA x-rays and are therefore generally reserved for situations where it is difficult for the patient to get an ordinary chest x-ray, such as when the patient is bedridden. In this situation, mobile X-ray equipment is used to obtain a lying down chest x-ray (known as a "supine film").
The cupola sign is seen on a supine chest or abdominal radiograph in the presence of pneumoperitoneum. It refers to dependent air that rises within the abdominal cavity of the supine patient to accumulate underneath the central tendon of the diaphragm in the midline. It is seen as lucency overlying the lower thoracic vertebral bodies.
Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver, visible on plain abdominal X-ray or chest X-ray. [1] Normally this causes no symptoms, and this is called Chilaiditi's sign. The sign can be permanently present, or ...
Aerophagia (or aerophagy) is a condition of excessive air swallowing, which goes to the stomach instead of the lungs.Aerophagia may also refer to an unusual condition where the primary symptom is excessive flatus (farting), belching (burping) is not present, and the actual mechanism by which air enters the gut is obscure or unknown. [1]
In intestinal perforation, gas may be visible under the diaphragm on chest x-ray while the patient is in an upright position. While x-ray is a fast and inexpensive to screen for perforation, an abdominal CT scan with contrast is more sensitive and specific for establishing a diagnosis as well as determining the underlying cause. [19]