How is diaphragmatic endometriosis diagnosed?

Diaphragmatic endometriosis can be difficult to confirm because symptoms may be subtle or absent, and imaging doesn’t always detect superficial implants. We start with your full symptom history and patterns, especially cyclical right upper abdominal, rib, chest, shoulder, or arm pain that flares around your period or with deep breaths or coughing. We then pair that with a targeted exam and a careful review of prior workups so we don’t miss look-alike or coexisting conditions.

Imaging such as MRI, and sometimes CT depending on the situation, can help raise suspicion, map anatomy, and guide surgical planning, but a normal scan does not rule it out. The most reliable way to diagnose diaphragmatic endometriosis is minimally invasive surgery (laparoscopy or robotic surgery) with deliberate inspection of the diaphragm and, when appropriate, removal of suspicious lesions for confirmation by pathology.

If symptoms suggest disease may extend into the chest (thoracic endometriosis), diagnosis may require coordination with a thoracic surgeon and, in select cases, a chest procedure such as VATS in addition to laparoscopy. Our team plans for this proactively when your history or imaging points in that direction, so you’re not left with an incomplete evaluation or surgery that isn’t equipped to address the full extent of disease.