A 77-year-old man was referred for an evaluation of dyspnea and decreased performance with exertion. There was a 2-year history of progressive shortness of breath and a 2-month history of severe exercise intolerance. For the last year, he had also complained of neck pain. There was a 20-pack-year smoking history, but he had stopped smoking 30 years before. His medical history was unremarkable.
Buszek, MC, Szymke, TE, Honet, JS, et al (1983) Hemidiaphragmatic paralysis: an unusual complication of cervical spondylosis.Arch Phys Med Rehabil64,601-603Ciccorella, DE, Daly, BD, Celli, BR Improved diaphragmatic function after surgical plication for unilateral diaphragmatic paralysis.Am Rev Respir Dis1992;146,797-799Drachler, DH, Koepke, GW, Weg, G Phrenic nerve injury from subclavian vein catheterization: diagnosis by electromyography.JAMA1976;236,2880-2881Gierada, DS, Slone, RM, Fleishman, MJ Imaging evaluation of the diaphragm.Chest Surg Clin N Am1998;8,237-280Higgs, SM, Hussain, A, Jackson, M, et al Long term results of diaphragmatic plication for unilateral diaphragm paralysis.Eur J Cardiothorac Surg2002;2,294-297Houston, JG, Fleet, M, Cowan, MD, et al Comparison of ultrasound with fluoroscopy in the assessment of suspected hemidiaphragmatic movement abnormality.Clin Radiol1995;50,95-98Large, FR, Heywood, LJ, Flower, CD, et al Incidence and etiology of a raised hemidiaphragm function after cardiopulmonary bypass.Thorax1985;40,444-447Lisboa, C, Pare, PD, Pertuze, J, et al Inspiratory muscle function in unilateral diaphragmatic paralysis.Am Rev Respir Dis1986;134,488-492Mellem, H, Johansen, B, Nakstad, P, et al Unilateral phrenic nerve paralysis caused by osteoarthritis of the cervical spine.Eur J Respir Dis1987;71,56-58