Abnormal sniff test

Case contributed by Assoc Prof Craig Hacking

Presentation

Previous pneumothorax and video-assisted thoracoscopic surgery. Progressive dyspnea, ? phrenic nerve injury during surgery

Patient Data

Age: 40 years
Gender: Male
Fluoroscopy

During normal breathing, there is reduced movement of the right hemidiaphragm compared to the left. During sniffing there is paradoxical movement of the right hemidiaphragm. Normal movement of the left hemidiaphragm is seen.

Conclusion:

Findings consistent with right hemidiaphragm palsy.

Case Discussion

Good example of diaphragm paralysis due to phrenic nerve palsy.

See sniff test for a description of the procedure.

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