In fluoroscopy, a continuous stream of X-rays passes through the patient, casting shadows of the heart, lungs, and diaphragm on a fluorescent screen. Because fluoroscopy reveals less detail than standard chest radiography, it's indicated only when diagnosis requires visualization of physiologic or pathologic motion of thoracic contents for example, to rule out paralysis in patients with diaphragmatic elevation.
Procedure and posttest care
Normal diaphragmatic movement is synchronous and symmetrical. Normal diaphragmatic excursion ranges from ¾" to 1 5/8 " (2 to 4 cm).
Diminished diaphragmatic movement may indicate pulmonary disease. Increased lung translucency may indicate loss of elasticity or bronchial obstruction. In elderly patients, the lowest part of the trachea may be displaced to the right by an elongated aorta.
Diminished or paradoxical diaphragmatic movement may indicate paralysis of the diaphragm; however, fluoroscopy may not detect such paralysis in patients who compensate for diminished diaphragm function by forcefully contracting their abdominal muscles to aid expiration.
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