• Diaphragmatic excursion was determined by percussion in 29 patients by two observers and then compared with measurements made from inspiration and expiration chest roentgenograms. The range of movement as determined by percussion was related to spirometric indices of ventilatory capacity. Our study showed wide interobserver variation in the clinical measurements and a poor correlation with diaphragmatic excursion measured roentgenographically. Although we were able to demonstrate a significant correlation between forced vital capacity (FVC) and clinically determined range of diaphragmatic movement, five patients had a reduced FVC despite the fact that the clinical determination of diaphragmatic movement was greater than 2 cm. Both observers missed paradoxical movement in the one patient in whom it was present. We conclude that percussion of the diaphragms for the purpose of estimating the range of movement is of limited clinical value and should no longer be recommended as part of the physical examination.
(Arch Intern Med 1981;141:878-880)