Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the primary imaging technique used for the investigation of a ruptured diaphragm?

1. X-ray

2. Ultrasound

3. CT

4. MRI

The correct answer is: CT

The primary imaging technique utilized for investigating a ruptured diaphragm is computed tomography (CT). This modality is preferred due to its ability to provide detailed cross-sectional images of the chest and abdominal structures, allowing for the clear visualization of diaphragm integrity, associated injuries, and any possible herniation of abdominal organs into the thoracic cavity. CT scans can effectively show subtle signs of diaphragm rupture that may not be easily detected on less sensitive imaging methods. While X-rays can sometimes indicate a suspected rupture through indirect signs, such as the presence of mediastinal shift or abnormal bowel gas patterns, they lack the precision and detail that CT offers. Ultrasound may be useful in certain clinical settings, particularly for evaluating fluid collections or in a pediatric population, but it is not the first-line investigation for a suspected diaphragm rupture. MRI provides excellent soft tissue contrast but is less commonly used in emergency settings for this type of injury, primarily due to concerns about availability and time constraints in acute care scenarios. Thus, CT stands out as the most effective and widely accepted imaging technique for diagnosing a ruptured diaphragm.