The diagnosis of diaphragm paralysis typically begins with a detailed physical examination, guided by the patient's reported symptoms. During this examination, findings from percussion and auscultation related to lung expansion are evaluated. Subsequently, a plain chest X-ray is performed to check for diaphragm elevation. If diaphragm paralysis is strongly suspected, fluoroscopy, which demonstrates diaphragm movement, is used to confirm the diagnosis. If deemed necessary, phrenic nerve electromyography (EMG) may also be conducted.