Chronic obstructive pulmonary disease chest x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Philip Marcus, M.D., M.P.H. [2]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]

Overview

On chest x-ray, the classic signs of COPD are overexpanded lung (hyperinflation), a flattened diaphragm, increased retrosternal airspace, and bullae. It can be useful to help exclude other lung diseases, such as pneumonia, pulmonary edema or a pneumothorax.

Chest X Ray

Chest Xray may reveal the following findings in the patients with COPD.^[1]

Images shown below are courtesy of RadsWiki

Emphysema

Signs of hyperinflation such as flattening of diaphragm
Increased retrosternal space
Hypovascularity
Long, narrow heart shadow

Patient #1: Paraseptal Emphysema

Patient #2: Paraseptal Emphysema

Chronic Bronchitis

Increased bronchovascular markings
Cardiomegaly
Right ventricular enlargement, prominent hilar vascular shadows, opacity in retrosternal air spaces (pulmonary hypertension)

References

↑ Torres M, Moayedi S (2007). “Evaluation of the acutely dyspneic elderly patient”. Clin. Geriatr. Med. 23 (2): 307–25, vi. doi:10.1016/j.cger.2007.01.007. PMID 17462519. Unknown parameter |month= ignored (help)

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[Old2007-1] Torres M, Moayedi S (2007). “Evaluation of the acutely dyspneic elderly patient”. Clin. Geriatr. Med. 23 (2): 307–25, vi. doi:10.1016/j.cger.2007.01.007. PMID 17462519. Unknown parameter |month= ignored (help)

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