title: Safety of needle electromyography of the diaphragm: Anterior lung margins in quietly breathing healthy subjects.
abstract: Controversy persists as to whether the lung interposes on the needle electrode insertion path during diaphragm electromyography (EMG).
  
  
  
  Using high-resolution ultrasonography, we measured the distances between the medial recess of the intercostal spaces (ICSs) around the mid-clavicular line (MCL) and the lung margin. We performed measurements bilaterally during quiet breathing in the seated and supine positions.
  
  
  
  We studied 10 young healthy men and found that, in the first ICS with the medial recess clearly (i.e., several cm) lateral to MCL (usually the eighth ICS), the distance between the recommended insertion site and the lung margin varied from 7.5 to 17 cm. The distance was slightly larger on the right side and in the supine position.
  
  
  
  This study confirms that properly conducted "trans-intercostal" needle EMG of the diaphragm is generally safe in healthy subjects. Muscle Nerve 54: 54-57, 2016.
authors.affiliation: Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center, Zaloška cesta 7, SI - 1525, Ljubljana, Slovenia.
authors.forename: Simon
authors.initials: S
authors.lastname: Podnar
authors.affiliation: Departments of Clinical Neurophysiology and Critical Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jonne
authors.initials: J
authors.lastname: Doorduin
mesh_terms: D000328:Adult; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000502:physiology*; D004576:Electromyography; D007839:Functional Laterality; D064368:Healthy Volunteers; D006801:Humans; D008168:Lung / Q000502:physiology*; D008297:Male; D009339:Needles; D012119:Respiration; D014463:Ultrasonography; D055815:Young Adult
keywords: anatomy; chest wall; diaphragm; lung; needle electromyography; ultrasonography