{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:34:18Z","timestamp":1787070858901,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Cervical septic arthritis can lead to complications such as epidural abscess, which may result in respiratory failure. We present a case of a 78-year-old male with cervical septic arthritis complicated by epidural abscess, leading to severe diaphragm dysfunction. Ultrasound evaluation revealed dysfunction of the left hemidiaphragm and compensatory activation of accessory respiratory muscles. Treatment included antibiotic therapy and corticosteroids, alongside respiratory support. After 21 days, improvements were observed in diaphragmatic function and respiratory muscle activation. Our findings highlight the importance of assessing both diaphragm and accessory respiratory muscles in cases of cervical septic arthritis with respiratory complications.<\/jats:p>","DOI":"10.4103\/sja.sja_328_24","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T12:01:14Z","timestamp":1727870474000},"page":"602-606","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["The role of extradiaphragmatic muscles\u2019 ultrasound on the diagnosis and follow-up of diaphragmatic dysfunction associated with cervical septic arthritis: A case report and literature review"],"prefix":"10.4103","volume":"18","author":[{"given":"Alessandro","family":"Menozzi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Sabbatini","sequence":"additional","affiliation":[{"name":"S.C. Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, 20097, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Umbrello","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, ASST Ovest Milano, New Hospital of Legnano, 20025, Legnano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Gotti","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Salvioni","sequence":"additional","affiliation":[{"name":"S.C. Medicina Interna, ASST Nord Milano, Ospedale Bassini, 20097, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Galimberti","sequence":"additional","affiliation":[{"name":"S.C. Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, 20097, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Pezzi","sequence":"additional","affiliation":[{"name":"S.C. Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, 20097, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Formenti","sequence":"additional","affiliation":[{"name":"S.C. Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, 20097, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"issue":"4 Suppl","key":"R1-20260427","doi-asserted-by":"crossref","first-page":"59S","DOI":"10.1177\/2192568218772048","article-title":"Etiology and surgical management of cervical spinal epidural abscess (SEA): A systematic review","volume":"8","author":"Stricsek","year":"2018","journal-title":"Global Spine J"},{"key":"R2-20260427","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1055\/s-0035-1565260","article-title":"Upper cervical epidural abscess in clinical practice: Diagnosis and management","volume":"6","author":"Al-Hourani","year":"2016","journal-title":"Global Spine J"},{"key":"R3-20260427","doi-asserted-by":"crossref","first-page":"160","DOI":"10.25259\/SNI_294_2020","article-title":"Diagnosis, and treatment of cervical epidural abscess and\/or cervical vertebral osteomyelitis with or without retropharyngeal abscess; a review","volume":"11","author":"Epstein","year":"2020","journal-title":"Surg Neurol Int"},{"key":"R4-20260427","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/resp.12916","article-title":"Prevalence and outcomes of diaphragmatic dysfunction assessed by ultrasound technology during acute exacerbation of COPD: A pilot study","volume":"22","author":"Antenora","year":"2017","journal-title":"Respirology"},{"key":"R5-20260427","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12890-018-0698-1","article-title":"Unilateral diaphragm paralysis: A dysfunction restricted not just to one hemidiaphragm","volume":"18","author":"Caleffi-Pereira","year":"2018","journal-title":"BMC Pulm Med"},{"key":"R6-20260427","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1164\/ajrccm.155.5.9154859","article-title":"Ultrasound evaluation of the paralyzed diaphragm","volume":"155","author":"Gottesman","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"R7-20260427","first-page":"267","article-title":"Unilateral diaphragmatic paralysis in spinal cord injury patients","volume":"18","author":"Carter","year":"1980","journal-title":"Paraplegia"},{"key":"R8-20260427","doi-asserted-by":"crossref","first-page":"604","DOI":"10.3171\/spi.2005.2.5.0604","article-title":"Diaphragmatic paralysis caused by cervical spondylosis. Case report","volume":"2","author":"Hayashi","year":"2005","journal-title":"J Neurosurg Spine"},{"key":"R9-20260427","first-page":"744348","article-title":"Ultrasound evaluation of diaphragm function in patients with cervical spinal cord injury: Case report","volume":"74","author":"Charco-Roca","year":"2024","journal-title":"Braz J Anesthesiol"},{"key":"R10-20260427","doi-asserted-by":"crossref","first-page":"183","DOI":"10.22603\/ssrr.2018-0015","article-title":"Hemidiaphragmatic paralysis due to cervical spondylosis: A case report","volume":"3","author":"Manabe","year":"2018","journal-title":"Spine Surg Relat Res"},{"key":"R11-20260427","doi-asserted-by":"crossref","first-page":"392","DOI":"10.3171\/spi.2006.5.5.392","article-title":"Cervical spine epidural abscess: Experience with microsurgical treatment in eight cases","volume":"5","author":"Muzii","year":"2006","journal-title":"J Neurosurg Spine"},{"key":"R12-20260427","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1177\/000313480306901014","article-title":"Intubation after cervical spinal cord injury: To be done selectively or routinely?","volume":"69","author":"Velmahos","year":"2003","journal-title":"Am Surg"},{"key":"R13-20260427","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.12998\/wjcc.v8.i12.2408","article-title":"Assessment of diaphragmatic function by ultrasonography: Current approach and perspectives","volume":"8","author":"Boussuges","year":"2020","journal-title":"World J Clin Cases"},{"key":"R14-20260427","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1164\/rccm.201503-0620OC","article-title":"Evolution of diaphragm thickness during mechanical ventilation. Impact of inspiratory effort","volume":"192","author":"Goligher","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"R15-20260427","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s40477-020-00462-x","article-title":"Evaluation of diaphragm thickening by diaphragm ultrasonography: A reproducibility and a repeatability study","volume":"24","author":"Cappellini","year":"2020","journal-title":"J Ultrasound"},{"key":"R16-20260427","doi-asserted-by":"crossref","first-page":"542","DOI":"10.4187\/respcare.04412","article-title":"Ultrasonographic assessment of diaphragm function in critically ill subjects","volume":"61","author":"Umbrello","year":"2016","journal-title":"Respir Care"},{"key":"R17-20260427","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s13613-020-00735-y","article-title":"Ultrasonographic assessment of parasternal intercostal muscles during mechanical ventilation","volume":"10","author":"Formenti","year":"2020","journal-title":"Ann Intensive Care"},{"key":"R18-20260427","doi-asserted-by":"crossref","first-page":"307","DOI":"10.5005\/jp-journals-10071-24125","article-title":"Evaluation of abdominal expiratory muscle thickness pattern, diaphragmatic excursion, and lung ultrasound score in critically ill patients and their association with weaning patterns: A prospective observational study","volume":"26","author":"Amara","year":"2022","journal-title":"Indian J Crit Care Med"},{"key":"R19-20260427","doi-asserted-by":"crossref","first-page":"1132335","DOI":"10.3389\/fnins.2023.1132335","article-title":"Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review","volume":"17","author":"Liu","year":"2023","journal-title":"Front Neurosci"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_328_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:37:45Z","timestamp":1787067465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_328_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_328_24","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-06-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}