Any Radiographers on here - diaphragm related query.

[RaeCJ82]

Just as the title suggests, are there any radiographers on here who may be able to help me with a query about the appearance of the diaphragm on x-rays and CT scans?

Giving this a little bump

DH is a radiographer i could ask him when he's back from work. What is it you are wanting to know

What would you like to know?

How easy would it be to miss unilateral or bilateral diaphragm paralysis on an x-ray if you were looking instead for heart related problems and can these problems be spotted on a supine chest CT. Thank you!

You don’t just look for one specific problem on any imaging modality, so a request relating to a heart problem wouldn’t stop someone commenting on any other unusual features. It would only be as obvious on either cxr or ct as it was and without more specific info it’s not really possible to comment on whether it could be missed (could be barn door obvious or not terribly obvious). There are plenty of things that can make a diaphragm look odd (and depending on what else is going on you wouldn’t necessarily be able to say for sure it was a paralysed (hemi)diaphragm or something else pushing/pulling it into an abnormal position). It would be unusual to have bilateral diaphragmatic paralysis without any signs/symptoms to suggest it. If this relates to a specific case/complaint you’d probably be better off discussing it with a doctor in real-life to see whether or not in retrospect something was missed.

Exactly what @Greybeardy said.

I recently had a chest x/ray looking for covid changes and something completely unrelated with my spine was picked up

Thanks @Greybeardy It's off the back of 6 months of symptoms which I've had numerous investigations for. However, the breathing problem has progressed and my automatic breathing has completely gone during the day. I'm manually breathing and my breathing is shallow as it feels hard to breathe. I have to take sleeping pills at night as I was jerking awake like I wasn't breathing correctly. My eyes when I woke up and closed my eyes would jerk backwards and forwards. I am still experiencing night sweats every night and wake with shoulder, neck and rib pain. The shoulder/trap pain persists all day. My GP says I'm anxious which I am, but it's due to the breathing issues.
I'm also being investigated by ENT as I do appear to have internal nasal valve collapse on one side, perhaps both, and am wondering whether this could be causing the breathing issues and the feeling that my body no longer knows how to make me breathe, or whether it could be phrenic nerve/diaphragm damage.

@Greybeardy would you be able to spot diaphragm paralysis on a chest CT? They took two - well they asked me to breathe in twice.

A static chest X-ray wouldn't necessary demonstrate paralysis, you need fluoroscopy to demonstrate diaphragmatic movement in real time.