Radiology, Vol 155, 289-293, Copyright © 1985 by Radiological Society of North America
The anterior diaphragmatic attachments: an anatomic and radiologic study with clinical correlates
PK Kleinman and V Raptopoulos
A study of the anterior attachments of the respiratory diaphragm was
performed using gross anatomic specimens, plain radiography, and computed
tomography with multiplanar image reformatting. The anterior portions of
the diaphragm are affixed to the lower six ribs and the sternum. The line
of attachment of each hemidiaphragm begins at the anterior axillary line
and extends cranially and medially to meet at the xiphoid process. These
structures can be visualized along with contiguous pathologic
subdiaphragmatic and/or infradiaphragmatic air collections. In the
semierect patient, free intraabdominal air may preferentially collect in
the anterior subdiaphragmatic regions rather than below the domes of the
diaphragm, providing a subtle but reliable indication of pneumoperitoneum.
An understanding of the normal anatomy of the anterior diaphragmatic
attachments is valuable in assessing a variety of anterior
paradiaphragmatic air collections.
